CommercialBilling CodesMedium impact
New and Updated Reimbursement Policies – May 2026
Highmark·Provider Bulletin
Effective date
May 25, 2026
We identified it
May 26, 2026
Summary
Highmark has issued multiple reimbursement policy updates with staggered effective dates from May through September 2026. Key changes include new care management codes, archived imaging criteria policies, updated skin substitute pricing, expanded rigid immobilization coverage, and revised telemedicine policies.
Action Required
By June 29, 2026: Update billing systems to include new care management codes 99497 and 99498. By July 1, 2026: Implement CMS flat rate pricing for non-BLA skin substitutes for Commercial plans (retroactive to Jan 1, 2026 for Medicare Advantage). By August 24, 2026: Add rigid immobilization codes 29086, 29130, 29131, 29200, 29240, 29260, 29280, 29440, 29450, 29520, 29530, 29540, 29550, 29580, 29581, and 29584 to Medicare Advantage billing. By September 1, 2026: Update telemedicine billing procedures to align with new CMS guidance.