Payment Policy

The online Payment Policy Reference Manual contains approved payment policies for all Commercial products offered by CareFirst. Payment policies are based on the most current research available at the time of policy development.

The policies in this Payment Policy Reference Manual are for informational use only. These policies are not intended to certify or authorize coverage availability and do not serve as an explanation of benefits or a contract. Member/subscriber coverage will vary from contract to contract and by line of business. Benefits will only be available upon the satisfaction of all terms and conditions of coverage. Some benefits may be excluded from individual coverage contracts.

These policies are not intended to replace or substitute the independent medical judgment of a practitioner or other health professional for the treatment of an individual.

CareFirst reserves the right to add, review, update and/or remove payment policies as necessary.

*For the purposes of this Manual, ‘Plan’ refers to all lines of business and affiliates of CareFirst BlueCross BlueShield.


Payment Policies