Share
- Home
- Resource Centers
- Medicare Resources
- Medicare Forms and Reference Materials
Share
- Medicare Resources
-
- Compliance
- D-SNP Member Benefits
- Guidelines
- Medicare Forms and Reference Materials
- Model of Care
- Medicare Policy Search
- Medicare Policy Search - Retired
- Medicare Provider Manual
-
Medicare Provider Updates
- Notice of Medicare Policy Updates for Sept. 1
- Notice of Medicare Policy Updates for Sept. 1
- Notice of Medicare Policy Updates for Sept. 1
- Medications to Require Medical Prior Authorization, Effective July 7
- Notice of Medicare Policy Updates for Aug. 1
- NOTICE OF MEDICARE POLICY UPDATES FOR July 1
- NOTICE OF MEDICARE POLICY UPDATES FOR JUNE 1
- Medications to Require Medical Prior Authorization, Effective May 12
- Notice of Medicare Policy Updates for May. 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE MAY 1
- NOTICE OF MEDICARE POLICY UPDATES FOR APR 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE MAR 12
- NOTICE OF MEDICARE POLICY UPDATES FOR MAR 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE JAN 27
- NOTICE OF MEDICARE POLICY UPDATES FOR FEB 1
- NOTICE OF MEDICARE POLICY UPDATES FOR JAN 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE NOV 23
- NOTICE OF MEDICARE POLICY UPDATES FOR DEC 1
- NOTICE OF MEDICARE POLICY UPDATES FOR NOV 1
- NOTICE OF MEDICARE POLICY UPDATES FOR OCT 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE SEPT 13
- NOTICE OF MEDICARE POLICY UPDATES FOR SEPT 1
- Notice of Medicare Payment Policy Updates for Aug. 1
- NOTICE OF MEDICARE POLICY UPDATES FOR AUG 1
- NOTICE OF MEDICARE POLICY UPDATES FOR JUL 1
- NOTICE OF MEDICARE POLICY UPDATES FOR JUN 1
- NOTICE OF MEDICARE POLICY UPDATES FOR MAY 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE APR 15
- NOTICE OF MEDICARE POLICY UPDATES FOR APR 1
- NOTICE OF MEDICARE POLICY UPDATES FOR MAR 1
- PA Medicare Policy Updates Effective February 1
- Prior Authorization No Longer Required for 200+ Services
- NOTICE OF MEDICARE POLICY UPDATES FOR Jan 1
- MEDICATIONS TO REQUIRE MEDICAL PRIOR AUTHORIZATION, EFFECTIVE DEC 18
- NOTICE OF MEDICARE POLICY UPDATES FOR DEC 1
- Webinar - Provider Claim Education: 2024 ICD-10-CM Updates & Highlights
- Highmark Wholecare has a New Address
- Notice of Medicare Policy Updates for Nov. 1
- Notice of Medicare Policy Updates for Oct. 1
- Notice of Medicare Policy Updates for Sept. 1
- Provider Claim Education: Evaluation & Management Edit Updates
- Claims Process Update with New Highmark Wholecare Member ID Numbers
- Medications to Require Medical Prior Authorization, Effective Aug. 15
- Notice of Medicare Policy Updates Effective December 1, 2025
- Provider Update Archive
- SSBCI Provider Attestation Form
Medicare Forms and Reference Materials
Last Updated: Monday, December 22, 2025
Medicare Assured Provider Manual
keyboard_arrow_downProvider Rebranding Reference Materials
keyboard_arrow_downHealthHelp Reference Materials
keyboard_arrow_downMedicare Assured Provider Forms and Reference Material
keyboard_arrow_downPHARMACY FORMS
CMS Standardized Part D Hospice Information Drug Request Form
Home Infusion Drug Request Form
Oncology and Supportive Therapy Request Form Submit requests via Navinet.
Second-Level Pharmacy Pricing Dispute Resolution Request Form
BEHAVIORAL HEALTH AUTHORIZATION REQUEST FORMS
Inpatient Authorization Request Form
Inpatient Substance Use Authorization Request Form
Outpatient Authorization Request Form
GENERAL PROVIDER FORMS & REFERENCES
2023 Highmark Wholecare Benefits
2026 Fraud, Prevention and Dectection Plan
Appointment of Representative Form
Annual Wellness Visit Tools and Reference Materials
CARC and RARC Adjustment Code Crosswalk
Care for Older Adults (COA) Form
Cataract Removal Questionnaire
Clinical Services Referral Guide
Consent to Release Health Information to Coordinate Physical and Behavioral Health Care
Family Planning Fax Cover Sheet
How to Use the Provider Portal Search Tool
ICD-10 Submitter-Provider Quick Start Guide
Late Notification FAQ - Medicare
Maternity Outcomes Authorization Form
Medicare Outpatient Observation Attestation
Medicare Outpatient Observation Notice
Medicare Outpatient Observation Notice Instructions
Non-Participating Provider Complaint Form
Obstetrical Needs Assessment Form (ONAF)
Opioid - CDC Guideline for Prescribing Opioids for Chronic Pain
Outpatient Program Exceptions Request – Please submit via Navinet.
Practice/Provider Change Request Form
About Highmark
About Highmark
Be Informed
Be Informed
Related Sites
Related Sites