New and Updated Reimbursement Policies

Highmark regularly issues new or updated reimbursement policies. Keep an eye on the Provider Resource Center (PRC) homepage for Special Bulletins announcing upcoming policy changes and the Reimbursement Policy page for specific policy updates.

Below is a list of recently updated Reimbursement Policies (RP):

January 9

RP-053 Gene and Cellular Therapy
Modifier LU was added to the policy with the direction that it is not to be used on claim lines billed to the Plan.

January 16

RP-038 Out of Network Services
Now applicable in the New York regions.

RP-065 Modifier Reduction Glossary
Administrative change: Format updated.