Published Date: 2025-11-18
Medicaid Prior Authorization List Updates
Please visit the Highmark Wholecare Provider Resource Center (PRC) for a list of procedure codes added to the Highmark Wholecare Medicaid Prior Authorization List that require prior authorization beginning on December 1, 2025.
To find these codes, please visit the PRC and click on the “Resource Centers” tab. Then, under “Medicaid Policy Search” scroll down to Provider Updates.
You may also search CPT codes in the Main Search Bar at the top of any page on the PRC to check prior authorization requirements.
