New and Updated Reimbursement Policies
Highmark regularly issues new or updated reimbursement policies. Keep an eye on the Provider Resource Center homepage for eBulletins announcing upcoming policy changes and the Reimbursement Policy page for updates.
Below is a list of upcoming and recently updated Reimbursement Policies (RP) and Medicare Advantage Reimbursement Policies (MRP):
Upcoming
New RPs
COVID-Related
Coding Changes
- MRP-001 Microsurgery : Removed code 63199.
- MRP-004 Prolonged Services : Removed codes 99311, 99312, 99313, 99314, 99317.
- RP-007 Multiple Procedure Payment Reduction (MPPR) for Certain Diagnostic Imaging Procedures : Added codes 0398T, 0716T, 0723T, 0721T.
- RP-011 Procedure Codes Not Applicable to Commercial Products : Removed performance measurement codes, which were used to create new RP-073.
- RP-042 Global Surgery and Subsequent Services : Added codes 0643T, 0714T, 0719T, 0725T, 0726T, 0727T, 0730T, 0737T.
- RP-053 Gene and Cellular Therapy : Added codes J3590, J9999, C9399.
- RP-072 Injection and Infusion Services : Added code J1551.
Administrative Updates
An Administrative Update is considered a minor change regarding the policy cross-reference section, reference section, header, or wording (e.g., correction of grammar).
To access Highmark reimbursement policy bulletins, select CLAIMS, PAYMENT & REIMBURSEMENT from the Provider Resource Center left-hand menu, and then click on Reimbursement Policy.
Provider News, Issue 4, 2022 | © 2022 Highmark Blue Cross Blue Shield West Virginia