Reimbursement Resources

Find the information, tools, and guidelines you need for efficient claims reimbursement.

Guidelines and Tips

Access documentation guidelines, coding tips, and more.

More Resources

Find the information you need for successful reimbursements.

Billing Highlights for Facilities

See the list of documents identifying the information required to bill specific facility types. Plus get helpful tips on how to provide the right information for each facility type.

APC Pricing Component Update Calendar

Find a record of the dates on which the Ambulatory Payment Classification (APC) pricing components were last updated.

Hospital Outpatient Prospective System (OPPS) Based Payment Method

Access Highmark's Hospital OPPS Based Payment Method Training Manual and Change Documentation for each quarter.

Medically Unlikely Update Schedule

View the dates on which Highmark updated its Medically Unlikely Edits (MUE) Table.

Physical Therapy, Occupational Therapy And Chiropractic Daily Bundle Maximum

Highmark's bundled daily reimbursement rate helps providers and members know the cost of treatment in advance, helping you predict revenue, collect member cost, share at time of service, and improve member experience.

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