- Billing NPI Reminder:The billing NPI submitted on claims must match the billing NPI on file with CareFirst,NPPES and ePREP (CareFirst CHPMD providers).
- Starting October 13, 2026,CareFirst CHPMD provider billing NPIs must match the billing NPI in MPRIME.
- If your billing NPI is not enrolled with CareFirst, learn how here:Adding a New Billing NPI
- PreAuth/Provider Portal/CFD applications will be unavailable Sun,Oct 11 from 10AM to 1PM for Facets members
Change Healthcare notifying individuals of data breach. Learn more here.
Machine Readable Provider Directory Data
Machine Readable Data for Provider Network and Prescription Formulary Content for Federally-Facilitated Marketplace (FFM) Qualified Health Plans (QHP)
As required by the Patient Protection and Affordable Care Act, for plan years beginning on or after January 1, 2016, qualified health plan (QHP) issuers in the Federally-Facilitated Marketplace (FFM) are required to publish information regarding their provider directories and formulary drug lists on their website in a machine-readable format.
This requirement increases and enhances consumer transparency by allowing software developers to access up-to-date, accurate and complete formulary and provider data needed to create innovative and informative tools.
In accordance with this requirement, the following files are available for use:
- Index data
- Plan data
- Medical provider data - file 1
- Medical provider data - file 2
- Medical provider data - file 3
- Medical provider data - file 4
- Medical provider data - file 5
- Medical provider data - file 6
- Medical provider data - file 7
- Medical provider data - file 8
- Dental provider data - file 1
- Dental provider data - file 2
- Dental provider data - file 3
- Dental provider data - file 4
- Dental provider data - file 5
- Prescription formulary data - file 1
- Prescription formulary data - file 2