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The policy bulletins on this web site were developed to assist Highmark Blue Cross Blue Shield in administering standard plan benefits and do not constitute a description of plan benefits. If you are a Highmark member, please review and discuss any questions regarding medical policies with your treating provider and refer to your specific benefit plan for the terms, conditions, limitations and exclusions of your coverage. The benefit plan will define which supplies and services are covered, excluded and/or subject to limitations and may differ from the medical policy bulletins.
Information contained in the policy bulletins does not constitute an offer or a guarantee of payment. Please note that if there is a conflict between the policy bulletin and a member’s benefit plan, the terms of the benefit plan will govern and will supersede the policy bulletin.
Medical policies do not constitute medical advice, nor are they intended to govern the practice of medicine. They are intended to reflect Highmark’s reimbursement and coverage guidelines. Treating providers are solely responsible for medical advice and related treatment of members. Coverage for services may vary for individual members based on the terms of their specific benefit plan and the specific facts of a particular situation.
Highmark retains the right to review and revise its medical policy guidelines at its sole discretion at any time without prior notice. These guidelines are the proprietary information of Highmark. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of the policy bulletins is permitted for individual use.
Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.
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