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Number Publication Name Issue Date
33-23-22 Addition of Procedure Codes for Vaccine Administration 9/29/2023
37-23-01 Street Medicine 9/29/2023
27-23-15 Pediatric Dental Periodicity Schedule Updates 9/28/2023
07-23-02 Update to Electronic Visit Verification Requirements for Pediatric Home Health Aide Services in FFS and Managed Care Delivery 9/20/2023
33-23-24 Updates for Childhood Nutrition and Weight Managment Services 9/13/2023
07-23-01 Pediatric Shiftcare Service for Beneficiaries Under 21 9/11/2023
99-23-09  2023 Healthcare Common Procedure Coding System (HCPCS) Updates, Fee Adjustments, and Other Procedure Code Changes 9/5/2023
33-23-21 Updates to the Family Planning Services Program Fee Schedule 9/1/2023
99-23-08 Updates to Guidelines for the Delivery Physical Health Services via Telehealth 8/2/2023
31-23-22 Updated Sterilization Consent Form 7/25/2023
33-23-08 Street Medicine 7/5/2023
33-23-18 Prior Authorization of Opioid Use Disorder Treatments - Pharmacy Service 6/30/2023
33-23-19 Prior Authorization of Progestational Agents- Pharmacy Services 6/30/2023
33-23-20 Prior Authorization of Tepezza (teprotumumab-trbw) - Pharmacy Services 6/30/2023
33-23-14 Clinical Prior Authorization of Non-PDL Durgs - Pharmacy Services 6/30/2023
33-23-12 Prior Authorization of Antiemetic/Antivertigo Agents- Pharmacy Services 6/29/2023
33-23-16 Prior Authorization of Cough and Cold Medications - Pharmacy Services 6/29/2023
33-23-13 Prior Authorization of Antiparasitics, Topical -Pharmacy Services 6/29/2023
33-23-15 Prior Authorization of Compounded Prescriptions - Pharmacy Service 6/29/2023
33-23-17 Prior Authorization of Hepatitis C Agents - Pharmacy Services 6/29/2023
33-23-11 Prior Authorization of Analgesics, Opioid Short-Acting - Pharmacy Services 6/28/2023
33-23-09 Prior Authorization of Amyloid-Targeted Monoclonal Antibodies (MABs) - Pharmacy Services 6/28/2023
99-23-07  Pennsylvania's Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program Periodicity Schedule 06/27/2023
33-23-07  MA Program Fee Schedule Update for an Additional Bivalent Dose of the SARS-CoV-2 Vaccine Manufactured by Pfizer, Inc. 6/20/2023
28-23-01 End-Dating COVID -19 Pharmacy Specimen Collection and Laboratory Testing Procedure Codes 6/12/2023
33-23-06 Billing Updates for COVID-19 Vaccine Counseling Only Visits for Beneficiaries Under the Age of 21 6/12/2023
33-23-05 Billing Updates for Vaccine Counseling Only Visits for Beneficiaries Under the Age of 21  6/12/2023
99-23-06 Evaluation and Management Fee Adjustments and Code Updates  6/1/2023
33-23-04 Additional Bivalent SARS-CoV-2 Vaccine Doses Manufactured by Merna, Inc. and Pfizer, Inc.  4/13/2023
33-23-03 Implementation of ADA Claim Form- Version 2019 4/4/2023
99-23-01 Medical Assistance Program Fee Schedule Revisions 4/1/2023
33-23-03  Administration of Booster Dose of SARS-CoV-2 Vaccine Manufactures by Novavax  3/24/2023
16-23-01 Coverage of Case Specific Training/Shadow Nursing for Private Duty/Shift Nursing Services for MA Beneficiaries Under 21 Years of Age 1/1/2023
99-22-11 Reinstatement of Provider Enrollment Requirements 12/29/2022
33-22-75 340B Drug Pricing Program - Dispensing 340B Purchased Drugs 12/22/2022
33-22-60 Prior Authorization of Hypoglycemics, Incretin Mimetics, Enhancers – Pharmacy Services  12/13/2022
33-22-76 Disposable Breast Milk Collection and Storage Bags and Breast Pump 12/13/2022
33-22-67 Coverage and Prior Authorization of Obesity Treatment Agents – Pharmacy Services 12/9/2022
33-22-72 Statewide Preferred Drug List (PDL) Updates – Pharmacy Services 12/9/2022
33-22-47 Prior Authorization of Monoclonal Antibodies – Anti- IL, Anti-IgE, Anti-TSLP (Formerly Monoclonal Antibodies – Anti-IL, Ant 12/9/2022
33-22-70 Prior Authorization of Platelet Aggregation Inhibitors- Pharmacy Services 12/8/2022
33-22-62 Prior Authorization of Hypoglycemics, SGLT2 Inhibitors – Pharmacy Services 12/8/2022
33-22-68 Prior Authorization of Ophthalmics, Anti-Inflammatories – Pharmacy Services  12/8/2022
33-22-69 Prior Authorization of Pituitary Suppressive Agents, LHRH – Pharmacy Services 12/8/2022
33-22-65 Prior Authorization of Lipotropics, Other – Pharmacy Services 12/7/2022
33-22-71 Prior Authorization of Stimulants and Related Agents– Pharmacy Services 12/7/2022
26-22-07 2023 Ambulance Fee Increases 11/10/2022
24-22-32 At-Home Over-The-Counter COVID-19 Test  11/10/2022
33-22-54 Prior Authorization of Dry Eye Treatments (Formerly Ophthalmics, Immunomodulators) – Pharmacy Services 11/10/2022
33-22-61 Prior Authorization of Hypoglycemics, Insulin and Related Agents – Pharmacy Services 11/10/2022
33-22-63 Prior Authorization of Hypoglycemics, TZDs – Pharmacy Services 11/10/2022
33-22-64 Prior Authorization of Immunomodulators, Atopic Dermatitis – Pharmacy Services 11/10/2022
33-22-66 Prior Authorization of NSAIDs – Pharmacy Services  11/10/2022
33-22-55 Prior Authorization of Dupixent (dupilumab) – Pharmacy Services  11/9/2022
33-22-56 Prior Authorization of GI Motility, Chronic Agents – Pharmacy Services 11/9/2022
33-22-58 Prior Authorization of Glucocorticoids, Oral – Pharmacy Services 11/9/2022
33-22-57 Prior Authorization of Glucocorticoids, Inhaled – Pharmacy Services 11/9/2022
33-22-59 Prior Authorization of Hepatitis C Agents – Pharmacy Services 11/9/2022
33-22-46 Prior Authorization of Antihemophilia Agents – Pharmacy Services  11/9/2022
33-22-37 Prior Authorization of Angiotensin Modulator Combinations – Pharmacy Services 11/9/2022
31-22-39 Prior Authorization of Bile Salts – Pharmacy Services 11/9/2022
33-22-53 Prior Authorization of Cytokine and CAM Antagonists – Pharmacy Services 11/9/2022
33-22-44 Prior Authorization of Antibiotics, GI and Related Agents – Pharmacy Services  11/8/2022
33-22-45 Prior Authorization of Antifibrotic Respiratory Agents (Formerly Idiopathic Pulmonary Fibrosis (IPF) Agents) – Pharmacy Services 11/8/2022
99-22-05 2022 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code ChangePrior Authorization of Antivirals, CMV – Pharmacy Services 11/8/2022
33-22-52 Prior Authorization of Corticotropin (formerly H.P. Acthar Gel) – Pharmacy Services 11/8/2022
33-22-40 Prior Authorization of Acne Agents, Oral – Pharmacy Services  11/4/2022
99-22-10 Enrollment of Providers for Medicare Cost-Sharing Only 11/4/2022
33-22-48 Prior Authorization of Antipsoriatics, Topical - Pharmacy Services 11/4/2022
33-22-43 Prior Authorization of Antianginal Agents - Pharmacy Services 11/4/2022
33-22-41 Prior Authorization of Alcohol Use Disorder Agents - Pharmacy Services 11/4/2022
33-22-16 SARS-CoV-2 Vaccine Booster Manufactured by Moderna Inc 10/17/2022
33-22-37 Updates to Pediatric SARS-CoV-2 Vaccines Manufactured by Pfizer, Inc. and Moderna, Inc.  9/28/2022
 07-22-02 Additions to the Medical Assistance Fee Schedule for Private Duty Nursing Services Provided to Beneficiaries Under the Age 9/26/2022
33-22-12 Vaccine Counseling Only Visits for Beneficiaries Under 21 9/20/2022
33-22-36 Administration of SARS-CoV-2 Vaccine Manufactured by Novavax 9/19/2022
99-22-07 Pennsylvania’s Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program Periodicity Schedule 9/19/2022
35-22-02 School-Based ACCESS Program Provider Handbook 9/15/2022
33-22-39 Adult Vaccine Procedure Code Updates and Additions1 9/14/2022
33-22-37 Updates to Pediatric SARS-CoV-2 Vaccines 9/8/2022
27-22-27 2022 Medical Assistance Program Dental Fee Schedule Update.  9/7/2022
31-22-39 Addition of Behavioral Health Providers to Certain Procedure Codes and other Procedure Code Changes 8/26/2022
99-22-05 2022 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code Change 8/26/2022
33-22-13 Adult Vaccine Procedure Code Updates and Additions 8/26/2022
33-22-04 SARS-CoV-2 (COVID-19) Oral Antiviral Treatments with emergency use authorization (EUA) from the U.S. Food and Drug Administ 1/25/2022
33-22-02 Prior Authorization of Aduhelm (aducanumab) – Pharmacy Services 1/12/2022
33-22-03 Prior Authorization of Xyrem (sodium oxybate) Xywav (calcium, magnesium, potassium, and sodium oxybates) Pharmacy Service 1/11/2022
33-22-05 Billing Procedure Update for Certified Registered Nurse Practitioners and Physician Assistants 1/7/2022
99-10-14 Missed Appointments 12/01/2010
Last updated on 10/19/2023 3:21:02 PM

 

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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.