Medicare AdvantageAdministrativeHigh impact
Medically Unlikely Edits: Providers Must Bill for Individual Dates, Instead of Span Dating
Highmark·PA, NY, DE, WV, NJ·Provider Bulletin
Effective date
Mar 1, 2026
We identified it
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.
Action Required
By February 28, 2026: Billing team must update all billing software and claim submission workflows to prohibit span dating for HCPCS procedure codes. (1) Configure billing system to require individual dates of service for each procedure code rather than accepting date ranges. (2) Update provider education materials and internal billing guidelines to eliminate span-dating practices. (3) Audit recent claim submissions (past 3-6 months) to identify any span-dated claims that may be reprocessed after March 1. (4) Brief all providers and billing staff on the new requirement during team meetings. (5) Test billing system changes before the effective date. Consequence: 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.