2025 Gold Card Fall Expansion: Streamlining Prior Authorizations for Providers

Highmark continues to expand its Enterprise Gold Card Program, which expedites prior authorization for clinicians who have demonstrated historical adherence to clinical criteria. Gold Carded providers are recognized for achieving authorization approval rates of 99% or higher for select modalities.

On Sept. 1, 2025, Highmark added 2,413 new clinicians to the Enterprise Gold Card Program, bringing the total Gold Carded clinicians to over 25,000.

New Modalities Added This Fall

In addition to the current offerings, this expansion includes Cardiac Devices, Cardiac Surgery, Capsule Endoscopy, Tonsil & Adenoid Surgery, Vascular Surgery and Prostatectomy modalities, along with the appropriate CPT codes, to expedite authorizations for these services.

How the Enterprise Gold Card Program Works

Highmark automatically enrolls clinicians, bi-annually, when eligibility criteria are met. Once Gold Carded, clinicians will enter the appropriate information for the Highmark member and, upon submission, will receive an immediate authorization number to attach to any subsequent claims. Where possible, clinicians can schedule follow-up services for patients before they leave the office. This helps patients get the care they need without delays.

You can view the current list of Gold Carded clinicians here on the Provider Resource Center > Claims & Authorization > Authorization Guidance > Gold Carding Program to verify if you are Gold Carded or your practice has Gold Carded clinicians. You can also review the Gold Card Prenotification Process for authorizations and eligibility criteria.

For questions about the Gold Card Program, please email goldcardinquiries@highmark.com.