Coverage profile
How Substrate can help you with CareFirst BlueCross BlueShield District of Columbia (NCA)
Substrate can help practices and billers with the following claims tasks for CareFirst BlueCross BlueShield District of Columbia (NCA).
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with CareFirst BlueCross BlueShield District of Columbia (NCA).
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for CareFirst BlueCross BlueShield District of Columbia (NCA).
2027 maternity billing research
When does CareFirst BlueCross BlueShield District of Columbia (NCA) change OB/GYN billing?
This chapter directs providers to follow CPT maternity reporting guidelines, including non-global services, and refers to Medical Policy 4.01.006A and Payment Policy PP CO 080.01. It states no implementation date for the 2027 maternity CPT deletion.
- Transition start
- Not stated in this chapter
- Billing start
- Not stated in this chapter
- Published
- Not stated in source
- Current As Of
- August 2026
Scope: Applicable local CareFirst BlueCross BlueShield medical business, subject to member contract. NASCO/FEP policies may differ. This chapter does not independently establish NCA-specific or GA applicability or maternity guidance for dental and vision products.
Provider Manual Chapter 9 — Policies and Procedures. Verify the payer source before claim submission.
Frequently asked questions
CareFirst BlueCross BlueShield District of Columbia (NCA) payer FAQs
Can I automate CareFirst BlueCross BlueShield District of Columbia (NCA) 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 CareFirst BlueCross BlueShield District of Columbia (NCA)?
The primary payer ID for CareFirst BlueCross BlueShield District of Columbia (NCA) is SB580. 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 CareFirst BlueCross BlueShield District of Columbia (NCA)?
The provider portal for CareFirst BlueCross BlueShield District of Columbia (NCA) is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for CareFirst BlueCross BlueShield District of Columbia (NCA)?
The 837P and 837I payer ID for CareFirst BlueCross BlueShield District of Columbia (NCA) is SB580 via Stedi.
What is the 835 payer ID for CareFirst BlueCross BlueShield District of Columbia (NCA)?
The 835 payer ID for CareFirst BlueCross BlueShield District of Columbia (NCA) is SB580 via Stedi.
What is the 270 payer ID for CareFirst BlueCross BlueShield District of Columbia (NCA)?
The 270 payer IDs for CareFirst BlueCross BlueShield District of Columbia (NCA) are SB580 via Stedi and BCDCC via Availity.
What states does CareFirst BlueCross BlueShield District of Columbia (NCA) operate in?
CareFirst BlueCross BlueShield District of Columbia (NCA) operates in DC and GA.
Routing reference
CareFirst BlueCross BlueShield District of Columbia (NCA) 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 | CareFirst BlueCross BlueShield District of Columbia (NCA)Source: Substrate payer directory · last refreshed |
|---|---|
| Operating states | DC, GASource: Substrate payer directory · last refreshed |
| 837P professional claims payer IDStedi | SB580Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | SB580Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | SB580Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | SB580Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | BCDCCSource: Availity payer catalog · catalog dated · matched by payer name |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: CareFirst BlueCross BlueShield District of Columbia (NCA). 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 name; matched record: CAREFIRST BCBS DISTRICT OF COLUMBIA. 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 ↗
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
CareFirst BlueCross BlueShield District of Columbia (NCA) 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.
- Eligibility / benefits phone
- (800) 322-6384DENTI-CAL
- Utilization management fax
(410) 781-7661UTILIZATION MANAGEMENT
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
fax(410) 781-7661 | Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
fax(800) 348-3804 | Other stated contextBenefit context: Co-Insurance |
| Hospital |
| phone(800) 322-6384 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(800) 335-8289 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(800) 441-9188 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Hospital, Hospital - Inpatient |
| phone(800) 451-0287 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Hospital, Hospital - Inpatient |
| phone(800) 524-0149 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(800) 676-2583 | Eligibility / benefits, Other stated contextBenefit context: Active Coverage; Benefit context: Contact Following Entity for Eligibility or Benefit Information |
| Health Benefit Plan Coverage, Hospital, Hospital - Inpatient |
| phone(800) 877-7195 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Vision (Optometry) |
| phone(800) 972-8088 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Hospital, Hospital - Inpatient |
| phone(800) 977-2273 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(833) 812-1800 | Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment |
| Chiropractic, Pharmacy |
| phone(844) 684-2255 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Vision (Optometry) |
| phone(855) 592-2895 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Vision (Optometry) |
| phone(855) 811-2218 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(877) 799-5783 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(888) 334-0870 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Mental Health |
| phone(800) 274-7767 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(800) 832-7850 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(844) 889-2273 | Utilization managementBenefit context: Co-Insurance |
| Professional (Physician) Visit - Office |
| phone(855) 343-4851 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(866) 470-6244 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(866) 773-2884 | Other stated context, Utilization managementBenefit context: Co-Insurance; Benefit context: Contact Following Entity for Eligibility or Benefit Information |
| Hospital - Inpatient |
| phone(877) 867-7610 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(866) 688-2242 | PharmacyBenefit context: Active Coverage |
| Pharmacy |
| phone(866) 322-1657 | Behavioral healthBenefit context: Active Coverage |
| Mental Health |
| phone(800) 344-5245 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 452-8507 | Other stated contextBenefit context: Active - Pending Investigation; Benefit context: Active Coverage |
| Hospital |
| phone(800) 572-2872 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 827-4814 | Other stated contextBenefit context: Limitations |
| Hospital - Inpatient |
| phone(800) 841-9659 | Other stated contextBenefit context: Co-Insurance |
| Hospital |
| phone(800) 920-2485 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(833) 592-9956 | Other stated contextBenefit context: Co-Insurance |
| Hospital |
| phone(844) 241-7087 | Other stated contextBenefit context: Co-Insurance |
| Chiropractic |
| phone(855) 798-2627 | Other stated contextBenefit context: Other or Additional Payor |
|
Phone and fax numbers sourced directly from the payer response
Other aliases
Also known as
- 00080
- 11102
- 1509
- 2425
- BCDCC
- DCBCBS
- DCBLS
- SB580
- SB580MA
- BCBS DC and National Capital Area
- CareFirst Blue Cross Blue Shield
- CAREFIRST BCBS DISTRICT OF COLUMBIA NCA
- CAREFIRST BLUECROSS BLUESHIELD
- CAREFIRST BCBS DISTRICT OF COLUMBIA