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HighmarkCommercial · Coverage · Provider Bulletin · DE, PA, WV, NYHigh impact

Highmark’s Telehealth Policy Will Be Updated on Sept. 1

Effective date
Sep 1, 2026
Identified
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.

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What to do

Action · 5 steps
01By Sept.
021, 2026: Billing team must update telehealth billing to only use CMS-approved codes and new AMA E/M codes (98000-98015).
03Update billing software to require POS code '02' for services outside patient's home and POS code '10' for services in patient's home.
04Review current telehealth services against CMS approved list and discontinue billing for non-approved services.
05Train providers that non-approved telehealth services must convert to in-person visits.

Codes mentioned

98000980019800298003980049800598006980079800898009980109801198012980139801498015

Original notice

Highmark’s Telehealth Policy Will Be Updated on Sept. 1
providers.highmark.com · Always check the source before changing claims.
View original ↗

Related changes

See all Highmark changes →
New and Updated Reimbursement Policies – September 2026HighNo effective date · Provider BulletinNew and Updated Reimbursement Policies – August 2026HighNo effective date · Provider BulletinBrowse every Highmark change in the policy list

Related policy hubs

Highmark policiesDE policy changesPA policy changesWV policy changesNY policy changesCode 98000Code 98001Code 98002Code 98003Code 98004Code 98005Code 98006Code 98007Code 98008Code 98009Code 98010Code 98011Code 98012Code 98013Code 98014Code 98015

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