Pharmacy Programs
Highmark Pharmacy Programs help ensure that members have access to the right medications, while managing costs, billing, and reimbursements.
Pharmacy Programs
Rx Processing Under Channel Alignment Program
This program helps ensure that drugs which should be billed through the pharmacy benefit are not billed under the medical benefit.
Free Market Health
Free Market Health is an innovative new specialty pharmacy program that aligns resources, risk, and accountabilities for pharmacy referrals and reimbursement.
Hemophilia and Bleeding Disorder Drug Program
Highmark is taking action to help members manage the high cost of hemophilia and bleeding disorder drugs.
Medical Injectable Drug Program
Highmark partners with Free Market Health to support the Medical Injectable Drug (MID) Program.
Pharmacy Medicare
Review the Medicare Part B Drug Website, which includes the annual Medicare Part B Drug Average Sale Price.
Pharmaceutical Management (Clinical Management Programs)
This coordinated program is designed to safeguard patients from potentially harmful drug interactions and side effects, optimize therapy, and promote appropriate drug utilization and compliance.
Program for Self-Administered Injectable or Oral Biotechnology Drugs
Highmark has taken steps to help manage the rising costs of medications by requiring members to obtain certain specialty drugs through an exclusive specialty provider.
Site of Care Drug Management Program
This program aims to improve the experience for members using certain medically billed infusion drugs that are considered safe and effective for administration outside of a hospital setting.
Pharmacy Policy Search
National Drug Code (NDC) Information
View Highmark's list of procedure codes that require NDC information to be reported on claims.
Pharmacy Authorization Forms
Additional Help
Want to better understand our Pharmacy Authorization process? Check out the Highmark Provider Manual.
Provider Service Center
Can't find an answer? Call us: 8 a.m. to 5 p.m. EST, Monday through Friday.
Clinical Services
Still have questions? Call us: 8:30 a.m. to 7 p.m. Monday through Friday, 8:30 a.m. to 4:30 p.m. Saturday and Sunday.
