CommercialPrior AuthMedium impact
Medications Added to FEP PPO Prior Authorization List—Effective February 1, 2026
CareFirst BlueCross BlueShield·Oncology, Rheumatology, Neurology +3 more·Prior Authorization
Effective date
Feb 1, 2026
We identified it
Jun 20, 2026
Summary
Effective February 1, 2026, CareFirst FEP PPO will add new medications to their prior authorization list for specialty drugs administered in outpatient, home, or office settings. These medications are covered under the medical benefit and require prior authorization and site of care management to control rising specialty drug costs.
Action Required
Before February 1, 2026: Billing team must access the updated Specialty Drug List on CareFirst's provider portal to identify which specific medications now require prior authorization. Update billing system to flag these medications for prior auth requirements. Train staff to verify prior authorization before administering or billing for specialty drugs covered under medical benefit. Claims will be denied without proper prior authorization.