Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
HighmarkMedicare Advantage · Administrative · Provider Bulletin · PA, NY, DE, WV, NJHigh impact

Medically Unlikely Edits: Providers Must Bill for Individual Dates, Instead of Span Dating

Act
by Feb 28, 2026
Effective date
Mar 1, 2026
Identified
Jul 4, 2026

Summary

Effective March 1, 2026, Highmark will reject or deny all span-dated (range-dated) claims subject to Medically Unlikely Edits (MUEs). Professional providers must submit HCPCS procedure codes with individual dates of service instead of date ranges to comply with National Correct Coding Initiative guidelines and correct coding principles.

Get alerts when payers change rules like this one

We check Highmark and other payers every day and email you when a change matches your specialty and state.

Get Highmark alertsPolicy Monitoring is free. No card required.

What to do

by Feb 28, 2026 · 7 steps
01Billing team must update all billing software and claim submission workflows to prohibit span dating for HCPCS procedure codes.
02Configure billing system to require individual dates of service for each procedure code rather than accepting date ranges.
03Update provider education materials and internal billing guidelines to eliminate span-dating practices.
04Audit recent claim submissions (past 3-6 months) to identify any span-dated claims that may be reprocessed after March 1.
05Brief all providers and billing staff on the new requirement during team meetings.
06Test billing system changes before the effective date.
07Consequence: Span-dated claims subject to MUEs will be automatically rejected or denied by Highmark's system, resulting in delayed or lost revenue and requiring resubmission with corrected dates.

Original notice

Medically Unlikely Edits: Providers Must Bill for Individual Dates, Instead of Span Dating
providers.highmark.com · Always check the source before changing claims.
View original ↗

Related changes

See all Highmark changes →
Medically Unlikely Edits Logic for Span-Dated Claims – New Implementation DateHighEffective Sep 1, 2026 · Provider BulletinBrowse every Highmark change in the policy list

Related policy hubs

Highmark policiesPA policy changesNY policy changesDE policy changesWV policy changesNJ policy changes

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account