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Latest Edition of MCG Care Guidelines
Highmark·Provider Bulletin
Effective date
Jul 27, 2026
We identified it
Apr 24, 2026
Summary
Highmark is implementing the 30th edition of MCG Care Guidelines effective July 27, 2026. All authorization requests with start of care dates on or after July 27, 2026 must use the new 30th edition guidelines, while requests before that date will continue using the 29th edition.
Action Required
By July 27, 2026: Review the 30th edition MCG Care Guidelines changes in the April Medical Policy Update newsletter. Update authorization request processes to ensure requests with start of care dates on or after July 27, 2026 reference the 30th edition guidelines. Continue using Predictal application in Availity Essentials for all authorization submissions.