- EFT Payments Issued as Checks:CareFirst identified on or around May 10 an issue in which some providers who were set up to receive ACH/EFT payments instead received paper checks. This issue remains under active investigation. Providers do not need to take any action at this time. We are working toward resolution and will continue to share updates as more information becomes available, including expected timing.
- ERAs Reflecting Check Information Instead of ACH:CareFirst is aware of an issue in which some Electronic Remittance Advices (ERAs) reflected check payment information instead of ACH/EFT details. This issue was resolved on May 29, 2026. CareFirst is currently working to reissue impacted ERAs to include the correct ACH/EFT information. Providers do not need to take any action at this time.
- PreAuth/Provider Portal/CFD applications will be unavailable Sat,July 18 from 8AM to 2PM and Sun, July 19 from 8AM to 2PM
Machine Readable Pricing Data
Machine-Readable Files Content for the Transparency in Coverage Final Rule
As required by the Transparency in Coverage Final Rule, plans and issuers are required to publicly display in-network provider negotiated rates, historical out-of-network and allowed amounts through Machine-Readable Files on an internet website. The Departments of Health and Human Services, Labor, and Treasury have delayed enforcement of this Final Rule until July 1, 2022.
In accordance with this mandate, the following files are available for use:
| No. | File Name | Download File |
|---|---|---|
| 1 | 2026-07-06_FEHBP-PSHBP-BlueChoice HMO_index.json | Download |
| 2 | 2026-06-28_carefirst netlease_index.json | Download |
| 3 | 2026-06-27_carefirst cfa_index.json | Download |
| 4 | 2026-06-27_carefirst hmo_index.json | Download |
| 5 | 2026-06-27_carefirst ncas_index.json | Download |
| 6 | 2026-06-27_carefirst par_index.json | Download |
| 7 | 2026-06-27_carefirst ppo_index.json | Download |
In-network rate files are identified by the words "in-network" in the description field of the file. Out-of-network files are identified by the words "allowed amount" in the description field. These definitions were defined by the CMS specifications on GitHub.
To access the files for a specific plan:
- Download the appropriate Table-Of-Contents (TOC) file from the list above
- Open the TOC file in an application that is compatible with the JSON file format
- Press Ctrl F and enter the plan EIN to search for URLs for the applicable plan
- Locate the desired URL(s) and copy it into a web browser to download the file(s)
- Open and extract the file
REMINDER: These files are meant to feed technology-based tools and are not meant to be used by individual consumers.
The information displayed in the files represents the rate Blue Cross Blue Shield Licensees have negotiated with their in-network providers for all covered items and services. This is not, however, an estimate of the cost patients will be responsible for paying for such item or service. Individual cost will vary depending upon the terms of the individual’s specific health insurance coverage and the structure of the reimbursement arrangement, if applicable. Blue Cross and Blue Shield Licensees have made reasonable efforts to ensure that the data displayed in the files is complete and accurate at the time it is published. The data is refreshed each month.