Several times annually, Highmark notifies providers of important policies and guidelines. The following notification is for your information and reference.
Highmark recently issued new reimbursement policies for inpatient readmissions and for gene and cellular therapy. In addition, the policies on anesthesia services and services not separately reimbursed have been revised.
A revised version of Highmark Reimbursement Policy Bulletin RP-033 was issued on October 1, 2019 to include additional information about dental and labor and delivery anesthesia services.
A revised version of Highmark Reimbursement Policy Bulletin RP-041 was issued on September 30, 2019 to add procedure code S9430.
Effective December 2, 2019, Highmark Reimbursement Policy Bulletin RP-050 documents readmission guidelines for Commercial and Medicare Advantage acute care inpatient admissions and reimbursement policies for these readmissions to promote more effective and cost-efficient health care through appropriate and safe hospital discharge of patients.
Effective October 1, 2019, Highmark Reimbursement Policy Bulletin RP-053 documents Highmark’s reimbursement guidelines for gene and cellular therapy drugs.
To access Highmark reimbursement policy bulletins, select CLAIMS, PAYMENT & REIMBURSEMENT from the Provider Resource Center main menu, and then click on Reimbursement Policy.
