Pricing Calculated to Five Decimal Points for Certain Drug Codes

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Pricing Calculated to Five Decimal Points for Certain Drug Codes

For: Professional and Facility Providers

Per Centers for Medicare and Medicaid Services (CMS) regulations, Highmark will apply pricing for specific drug codes up to five decimal points when required, starting July 17, 2026. This five-decimal precision is used in calculating provider allowances to ensure compliance and accurate reimbursement.

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