Highmark West Virginia policy updates
Track new and updated Highmark West Virginia policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Preventable Serious Adverse Events | Highmark West Virginia | Reimbursement | — | Modified | Jul 27, 2026 |
| FEP list of procedures and durable medical equipment requiring prior authorization | Highmark West Virginia | Reimbursement | — | Modified | Feb 1, 2026 |
| Highmark Prior Authorization / Managed Procedure & DME Listing (Effective 10/1/2025) | Highmark West Virginia | Reimbursement | — | Modified | Oct 1, 2025 |
| Noom: Weight Management — Coverage Criteria | Highmark West Virginia | Clinical | Bariatric & Obesity Management | Modified | — |
| Preferred Oncology Products (biosimilars and supportive care agents) — Coverage Criteria | Highmark West Virginia | Clinical | Hematology/Oncology | Modified | — |
| Medication prior authorization form (Contrave) | Highmark West Virginia | Clinical | Pharmacy & Specialty Drugs | Modified | — |
| Dupixent (dupilumab) prior authorization request - coverage criteria | Highmark West Virginia | Clinical | Pharmacy & Specialty Drugs | Modified | — |
| Vyleesi (bremelanotide) prior authorization form coverage criteria | Highmark West Virginia | Clinical | Pharmacy & Specialty Drugs | Modified | — |
| Autism Spectrum Disorders — ABA authorization form and billing guidance | Highmark West Virginia | Reimbursement | — | Modified | — |
| Procedure Terminology-Based Combinations | Highmark West Virginia | Reimbursement | — | Modified | — |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
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Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.