Effective October 1, 2024, a primary care physician (PCP) written referral to in-network specialists will no longer be required for MedStar Family Choice members. This change is designed to improve access to care and streamline the member and provider experience.
While members can now access in-network specialists without a written referral, referrals to an out of network specialist will require a written referral and prior authorization. It is essential that you utilize the MedStar Family Choice Quick Prior Authorization Guide, which details the services requiring prior authorization, to ensure timely approval for specialized care. For the latest version of the MedStar Family Choice Quick Prior Authorization Guide, please visit the Provider News section of our website at MedStar Family Choice Provider News.
Claims for services provided by in-network specialists should be submitted as usual, with all necessary documentation included for efficient processing.
Information current as of: