CommercialCoverageHigh impact
Highmark’s Telehealth Policy Will Be Updated on Sept. 1
Highmark·DE, PA, WV, NY·Provider Bulletin
Effective date
Sep 1, 2026
We identified it
May 26, 2026
Summary
Effective Sept. 1, 2026, Highmark will restrict telehealth services to only those approved by CMS (nearly 300 CPT codes) and new AMA-approved E/M telehealth codes for audio-video (98000-98007) and audio-only (98008-98015) services. Services not on these approved lists will require in-person visits.
Action Required
By Sept. 1, 2026: Billing team must update telehealth billing to only use CMS-approved codes and new AMA E/M codes (98000-98015). Update billing software to require POS code '02' for services outside patient's home and POS code '10' for services in patient's home. Review current telehealth services against CMS approved list and discontinue billing for non-approved services. Train providers that non-approved telehealth services must convert to in-person visits.