ValueBlue Partial Capitation Reimbursement Begins Jan. 1, 2027
- WPA/NEPA
- CPA/SEPA
- WV
Published Date: Fri, Oct 30, 2026 NEW
Primary care providers (PCPs) participating in ValueBlue will receive monthly partial capitation payments, effective Jan. 1, 2027. Not enrolled? Sign your amendment by Dec. 1, 2026.
Why it matters: PCPs who don’t join ValueBlue will continue to receive fee-for-service payments. However, capitated codes within Highmark’s community fee schedule will be reduced by 20% on April 1, 2027.
What to do:
- Visit the ValueBlue page for the program guide and capitated code list. [Sign in to Availity Essentials first to see secure Provider Resource Center (PRC) content.]
- Review the 2027 ValueBlue base capitation rate and performance adjustment factor (PAF):
- wpa/ nepa
- cpa/ sepa
- Enroll in ValueBlue Connect by Dec. 1, 2026, to earn additional incentives.
- Register for an upcoming webinar to learn more about both programs.
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