Reimbursement Policy

Archived Policies

Highmark's reimbursement policies address claims reimbursement logic as opposed to clinical information, which is addressed on medical policy. Each reimbursement policy includes information pertaining to all Highmark markets as indicated in the header, with state specific variations indicated within the policy bulletin.

Effective July 6, 2021, Medicare Advantage reimbursement policies will be published on this page. Policies specific to Medicare Advantage will have a reimbursement policy number that begins with MRP. Check each individual policy to confirm which market it pertains to.

History versions of reimbursement policies are stored within the PDF files. Click the "View History" link on the first page of the policy to view previous versions.

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