A newsletter for the Highmark Blue Shield providers in central Pennsylvania, the Lehigh Valley, northeastern Pennsylvania and southeastern Pennsylvania
Issue 7, July 2023
Correction: Reimbursement Changes to Incident To ServicesLast month’s Provider News article about Reimbursement Policy (RP)–010: Incident To Billing Services and Advanced Practice Provider Reductions contained incorrect information.
Below is the corrected update for RP-010:
RP-010 Incident To Billing Services and Advanced Practice Provider Reductions 
For West Virginia: West Virginia was inadvertently checked as an applicable Commercial market in the current version of RP-010. This will be corrected in the updated policy. Highmark will continue to reimburse for these services for Medicare Advantage products, as well as for Mid-Level Practitioners and Advanced Practice Providers who have been enumerated and bill using their own provider ID.*
For Pennsylvania: Incident To services for Commercial products will no longer be recognized, effective January 1, 2024. Highmark will continue to reimburse for these services for Medicare Advantage products, as well as for Mid-Level Practitioners and Advanced Practice Providers.*
For Delaware: Only non-Primary Care Physician (PCP) Incident To services will no longer be applicable to the policy, effective January 1, 2024. PCP Incident To services will still be covered. Highmark will also continue to reimburse for these services for Medicare Advantage products, as well as for Mid-Level Practitioners and Advanced Practice Providers.*
For New York: New York was inadvertently checked as an applicable Commercial market in the current version of RP-010. This will be corrected in the updated policy. Highmark will continue to reimburse for these services for Medicare Advantage products, as well as for Mid-Level Practitioners and Advanced Practice Providers who have been enumerated and bill using their own provider ID.*
*Direction for continued reimbursement for Mid-Level Practitioners and Advanced Practice Providers will be published in a new policy, RP-068 (see NEW: RP-068 further down in this article), effective on September 25, 2023.
NEW: RP-068 Mid-Level Practitioners and Advanced Practice Providers
Highmark has created RP-068 to provide direction on reimbursement for Mid-Level Practitioners and Advanced Practice Providers. (NOTE: This policy will be available on the PRC on September 25.)
