Highmark Removes 81 Codes from Prior Auth List
Published Date: Tue, Nov 10, 2026 NEW
Codes removed from Highmark’s prior authorization list, effective Nov. 1, 2026, include:
- 68 “add-on” codes deemed no longer necessary, as the primary code is considered clinically sufficient
- 6 tonsillectomy/adenoidectomy codes
- 5 codes related to patient lifts/frames
- 1 code (37243) often used for uterine fibroid removal
- 1 code (J0565) that was retired by the drug manufacturer
All 81 codes can be viewed here.
Our List of Procedures and Durable Medical Equipment (DME) Requiring Authorization is subject to change. To view the current list, go to the Provider Resource Center’s Obtaining Authorizations page.
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