Payment Policies
Last Updated: Monday, October 30, 2023
All Highmark Wholecare Products Payment Policies:
Hot/Cold Packs and Heparin Flush - Payment Policy
Screening, Brief Intervention, and Referral to Treatment (SBIRT) Reimbursement
Medicare Payment Policies:
Diabetic Retinal Eye Exam
Maximum Units of Service - Claims Payment Policy - Outpatient and Professional
Opioid Treatment Providers (OTP)
Medicaire Readmission Policies
PA Medicaid Payment Policies:
ICD-10-CM Excludes Notes Policy
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Maximum Units of Service - Claims Payment Policy - Outpatient and Professional
NDC Codes
Preventative Visits and Sick Visits on the Same Day
Telemedicine Services
Use of CMS NCDs and LCDs
Medicaid Readmission Policy
Archived Policies
Sepsis-3
