CommercialReimbursementHigh impact
Upcoming Fee Schedule Changes, Including Highmark’s Annual Adjustment
Highmark·DE, NY, PA, WV·Reimbursement
Effective date
Jul 1, 2026
We identified it
Apr 27, 2026
Summary
Highmark will update its standard professional fee schedules across all regions effective July 1, 2026, with additional updates to DME schedules (DE, PA, WV) on July 1st and Commercial Lab schedules (NY) on August 1st. Updated fee schedules will be available for review in Availity beginning June 1, 2026.
Action Required
By June 1, 2026: Billing team must review updated fee schedules in Availity Essentials (Claims and Payments > Fee Schedule Listing or Provider Resource Center > Claims > Reimbursement Resources). Update billing software with new reimbursement rates before July 1, 2026 effective date. For NY practices, also review Commercial Lab fee schedules available July 1st for August 1st implementation.