Coverage profile
Work Capital Blue Cross of Pennsylvania 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.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Capital Blue Cross of Pennsylvania.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Capital Blue Cross of Pennsylvania.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Capital Blue Cross of Pennsylvania.
Other aliases
Also known as
- 00361
- 100952
- 10325
- 12B61
- 23045
- 23045MA
- 24705
- 361
- 7705
- CBC01
- PABLC
- PACAPB
- Capital Blue Cross Pennsylvania
- Capital Blue Cross of Pennsylvania - Medicare Advantage
- CAPITAL BLUE CROSS
BlueCard home-plan routing
BCBS prefixes for Capital Blue Cross of Pennsylvania
These 109 member ID prefixes resolve to Capital Blue Cross of Pennsylvania as their terminal payer. Open a prefix to review its home plan, state, payer ID, and published routes.
Member ID prefixes
AIRBCBS prefixBGYBCBS prefixBHBBCBS prefixBYSBCBS prefixCERBCBS prefixCHIBCBS prefixCHPBCBS prefixCHYBCBS prefixCIKBCBS prefixCIOBCBS prefixCIVBCBS prefixCOABCBS prefixCOYBCBS prefixCRABCBS prefixCTKBCBS prefixDDLBCBS prefixDHIBCBS prefixDKJBCBS prefixDLKBCBS prefixDNTBCBS prefixEAGBCBS prefixEEXBCBS prefixEOFBCBS prefixERPBCBS prefixESIBCBS prefixEZFBCBS prefixGFDBCBS prefixGGRBCBS prefixGOJBCBS prefixHGHBCBS prefixHHXBCBS prefixHPIBCBS prefixHRCBCBS prefixHROBCBS prefixIANBCBS prefixICYBCBS prefixIEPBCBS prefixIOCBCBS prefixIOWBCBS prefixIOZBCBS prefixIQCBCBS prefixITHBCBS prefixJBOBCBS prefixJCMBCBS prefixJCPBCBS prefixKISBCBS prefixKWQBCBS prefixLBCBCBS prefixLLPBCBS prefixLUBBCBS prefixLUPBCBS prefixLUQBCBS prefixLUTBCBS prefixMGBBCBS prefixNHGBCBS prefixNHUBCBS prefixOFBBCBS prefixPACBCBS prefixPCOBCBS prefixPCUBCBS prefixPFXBCBS prefixPHJBCBS prefixPIGBCBS prefixPNHBCBS prefixPNLBCBS prefixPPHBCBS prefixPPZBCBS prefixPTKBCBS prefixPTMBCBS prefixPZLBCBS prefixPZUBCBS prefixPZXBCBS prefixPZZBCBS prefixRLQBCBS prefixRNABCBS prefixRSTBCBS prefixSASBCBS prefixSHGBCBS prefixSLUBCBS prefixSRHBCBS prefixSTDBCBS prefixSUEBCBS prefixTRIBCBS prefixTUABCBS prefixVIFBCBS prefixVLIBCBS prefixVLVBCBS prefixVLXBCBS prefixWKCBCBS prefixWKPBCBS prefixWMKBCBS prefixWSSBCBS prefixYCIBCBS prefixYWABCBS prefixYWBBCBS prefixYWCBCBS prefixYWDBCBS prefixYWEBCBS prefixYWFBCBS prefixYWGBCBS prefixYWHBCBS prefixYWKBCBS prefixYWMBCBS prefixYWNBCBS prefixYWPBCBS prefixYWTBCBS prefixYWVBCBS prefixYWWBCBS prefixYWZBCBS prefix
2027 maternity billing research
When does Capital Blue Cross of Pennsylvania change OB/GYN billing?
Capital Blue Cross begins visit-based prenatal billing on 2026-09-01 after pregnancy confirmation. Its stated 2027 policy moves labor management, delivery, and postpartum care to component reporting on 2027-01-01.
- Transition start
- 2026-09-01
- Billing start
- 2027-01-01
- Published
- 2026-07-01
- Current As Of
- September 2026
Scope: Capital Blue Cross bulletin expressly lists CHIP, EPO, FEP PPO, HMO, Medicare Advantage HMO/PPO, POS, PPO, and Traditional and Comprehensive products.
FP-01.011 Obstetrical Maternity Services. Verify the payer source before claim submission.
Frequently asked questions
Capital Blue Cross of Pennsylvania payer FAQs
How do I check claim status with Capital Blue Cross of Pennsylvania?
Providers check Capital Blue Cross of Pennsylvania via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Capital Blue Cross of Pennsylvania 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 of Pennsylvania?
The primary payer ID for Capital Blue Cross of Pennsylvania is 100952. 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 of Pennsylvania?
The provider portal for Capital Blue Cross of Pennsylvania is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Capital Blue Cross of Pennsylvania?
The 837P and 837I payer ID for Capital Blue Cross of Pennsylvania is 100952 via Stedi.
What is the 835 payer ID for Capital Blue Cross of Pennsylvania?
The 835 payer ID for Capital Blue Cross of Pennsylvania is 100952 via Stedi.
What is the 270 payer ID for Capital Blue Cross of Pennsylvania?
The 270 payer IDs for Capital Blue Cross of Pennsylvania are 100952 via Stedi and 100952 via Availity.
What is the 276 payer ID for Capital Blue Cross of Pennsylvania?
The 276 payer ID for Capital Blue Cross of Pennsylvania is 100952 via Stedi.
What state does Capital Blue Cross of Pennsylvania operate in?
Capital Blue Cross of Pennsylvania operates in PA.
Routing reference
Capital Blue Cross of Pennsylvania 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 Cross of PennsylvaniaSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | PASource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 100952Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 100952Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 100952Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 100952Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 100952Enrollment requiredSource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 100952Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Capital Blue Cross of Pennsylvania. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: CAPITAL BLUE CROSS PENNSYLVANIA. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Capital Blue Cross of Pennsylvania. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Capital Blue Cross of Pennsylvania phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Dental phone
- (800) 613-2624CAPITAL BLUE CROSS
- Prior authorization fax
(866) 411-2573ACUTE INPATIENT REHABILITATION ADMISSION PRECERTIFICATION, SKILLED NURSING FACILITY ADMISSION PRECERTIFICATION
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
fax(866) 411-2573 | Prior authorizationBenefit context: Co-Insurance |
| Hospital |
fax(866) 411-2585 | Prior authorizationBenefit context: Co-Insurance |
| Hospital |
| phone(800) 524-0149 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(855) 811-2218 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(866) 688-2242 | Other stated context, PharmacyBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage, Pharmacy |
| phone(800) 613-2624 | DentalBenefit context: Active Coverage |
| Dental Care |
| phone(800) 216-9748 | Behavioral healthBenefit context: Active Coverage |
| Mental Health |
| phone(866) 322-1657 | Behavioral healthBenefit context: Active Coverage |
| Mental Health |
| phone(800) 452-8507 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 664-2583 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(800) 753-1276 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(800) 842-1768 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 905-4102 | Other stated contextBenefit context: Active Coverage |
| Vision (Optometry) |
| phone(800) 676-2583 |
|
Phone and fax numbers sourced directly from the payer response