Since this program was initially communicated in Sept. 2025, the two medical policies that outline procedures and site of care clinical review requirements were modified. Medical policies Z-109 (Commercial) and Z-129 (Medicare Advantage) now include exclusions that introduce more flexibility.
ECHO Health will manage claims payments for Western and Northeastern New York beginning January 26, 2026. Click here for more information.
Top News and Resources for Providers
Never miss an update - Access exclusive newsletters, news, and policy updates from Highmark.
Keep up with the latest information from Highmark.
Stay informed of the latest medical policy changes and updates.
Browse our archive of previous newsletters, provider updates, and Special Bulletins.
Is prior authorization needed? Search for codes and get guidance on the process
Search for and review Highmark medical policies and get the latest updates.
Find out about Highmark’s pharmacy programs, formularies, and policies.
Can't find an answer? Call us: 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m. EST, Monday through Friday.
Still have questions? Call us: 8 a.m. to 5 p.m. EST, Monday through Friday.