Coverage profile
Work CAPITAL BLUE CROSS across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for CAPITAL BLUE CROSS.
Other aliases
Also known as
- CAPBLUECRO
BlueCard home-plan routing
BCBS prefixes for CAPITAL BLUE CROSS
These 47 member ID prefixes resolve to CAPITAL BLUE CROSS as their terminal payer. Open a prefix to review its home plan, state, payer ID, and published routes.
Member ID prefixes
A2IBCBS prefixA2KBCBS prefixA2LBCBS prefixA2MBCBS prefixA2NBCBS prefixA2RBCBS prefixA3EBCBS prefixA3RBCBS prefixA3SBCBS prefixA4EBCBS prefixA4GBCBS prefixA4MBCBS prefixA4QBCBS prefixA4ZBCBS prefixA5CBCBS prefixA5GBCBS prefixA5JBCBS prefixA5OBCBS prefixA6IBCBS prefixA6OBCBS prefixA7JBCBS prefixAHCBCBS prefixB5EBCBS prefixB7IBCBS prefixB7QBCBS prefixD6IBCBS prefixEBHBCBS prefixEDGBCBS prefixEPPBCBS prefixEPWBCBS prefixFZQBCBS prefixI3LBCBS prefixIJYBCBS prefixIYDBCBS prefixL2BBCBS prefixL7BBCBS prefixPAABCBS prefixPEBBCBS prefixQMQBCBS prefixS5VBCBS prefixSLXBCBS prefixSVFBCBS prefixT2VBCBS prefixWPBBCBS prefixXRMBCBS prefixYVIBCBS prefixYWJBCBS prefix
2027 maternity billing research
When does CAPITAL BLUE CROSS change OB/GYN billing?
Reimbursement policy FP-01.011, Obstetrical Maternity Services, goes into effect September 1, 2026 and prepares providers for the 2027 move away from global obstetric codes toward visit-based reporting. Before September 1, 2026, the first prenatal visit after confirmation of pregnancy continues to use bundled codes. On or after September 1, 2026, that first prenatal visit requires an E/M code with modifier TH and ICD-10-CM Z3A.XX for weeks of gestation. FP-01.011 also addresses obstetrics and maternity services transitioning from global-based billing to visit/service-based billing effective January 1, 2027.
- Transition start
- 2026-09-01 — first prenatal visit moves to E/M + TH
- Billing start
- 2027-01-01 — global-based billing transitions to visit/service-based billing
- Published
- Not stated in source
- Current As Of
- October 2026
Scope: Capital Blue Cross reimbursement policy FP-01.011. The maternity sentences do not name a narrower product line.
FP-01.011 Obstetrical Maternity Services. Verify the payer source before claim submission.
Frequently asked questions
CAPITAL BLUE CROSS payer FAQs
Can I automate CAPITAL BLUE CROSS portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for CAPITAL BLUE CROSS?
The primary payer ID for CAPITAL BLUE CROSS is 361. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for CAPITAL BLUE CROSS?
The provider portal for CAPITAL BLUE CROSS is https://apps.availity.com/. Available features depend on the payer and your account.
Routing reference
CAPITAL BLUE CROSS payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | CAPITAL BLUE CROSSSource: Substrate payer directory · data last changed |
|---|
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.