Coverage profile
Work Highmark of Pennsylvania across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Highmark of Pennsylvania.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Highmark of Pennsylvania.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Highmark of Pennsylvania.
Other aliases
Also known as
- 100338
- 10046
- 100900
- 10264
- 10524
- 2413
- 35145
- 54771
- 95462
- AJOXG
- PABCBS
- PABLS
- SB865
- SB865MA
- SZXAY
- First Priority Life Insurance Company (FPLIC) Out-of-Area Claims
- Highmark Blue Cross Blue Shield
- Highmark Blue Cross Blue Shield Pennsylvania
- Highmark Blue Cross Blue Shield Pennsylvania Professional
- Highmark Blue Shield
- Highmark of Pennsylvania - Medicare Advantage
- Keystone Health Plan West - Community Blue HMO
- BCBSPA
- HIGHMARK BCBS PENNSYLVANIA PROFESSIONAL
- HIGHMARK BCBS PENNSYLVANIA
BlueCard home-plan routing
BCBS prefixes for Highmark of Pennsylvania
These 301 member ID prefixes resolve to Highmark of Pennsylvania as their terminal payer. Open a prefix to review its home plan, state, payer ID, and published routes.
Member ID prefixes
A2UBCBS prefixA2WBCBS prefixA8KBCBS prefixA8LBCBS prefixA9ZBCBS prefixAHEBCBS prefixAJNBCBS prefixAWRBCBS prefixB3LBCBS prefixB4FBCBS prefixB5BBCBS prefixB7JBCBS prefixB8GBCBS prefixB8KBCBS prefixBOVBCBS prefixBWJBCBS prefixBWPBCBS prefixC3RBCBS prefixC4KBCBS prefixC5EBCBS prefixCDEBCBS prefixCDJBCBS prefixCDSBCBS prefixCEDBCBS prefixCJCBCBS prefixCJDBCBS prefixCJWBCBS prefixCKEBCBS prefixCLEBCBS prefixCLVBCBS prefixCMUBCBS prefixCNPBCBS prefixCWMBCBS prefixD2HBCBS prefixD2IBCBS prefixD2LBCBS prefixD3BBCBS prefixD3CBCBS prefixD3DBCBS prefixDCMBCBS prefixDDKBCBS prefixDFTBCBS prefixDFWBCBS prefixDLMBCBS prefixDNRBCBS prefixDTRBCBS prefixDTSBCBS prefixE6EBCBS prefixE6GBCBS prefixE6JBCBS prefixE6KBCBS prefixE6OBCBS prefixE6UBCBS prefixE6YBCBS prefixE7GBCBS prefixE7JBCBS prefixE7KBCBS prefixE7LBCBS prefixE7PBCBS prefixE9LBCBS prefixE9RBCBS prefixEDHBCBS prefixELSBCBS prefixF3CBCBS prefixF3SBCBS prefixF7TBCBS prefixF8YBCBS prefixF9HBCBS prefixF9RBCBS prefixFASBCBS prefixFDEBCBS prefixFDFBCBS prefixFDNBCBS prefixFFRBCBS prefixFJRBCBS prefixFPRBCBS prefixFYOBCBS prefixFZOBCBS prefixG3BBCBS prefixG3DBCBS prefixG3EBCBS prefixG5LBCBS prefixG5UBCBS prefixG5YBCBS prefixG6DBCBS prefixG7DBCBS prefixG7RBCBS prefixG8EBCBS prefixGCNBCBS prefixGCYBCBS prefixGGABCBS prefixGGTBCBS prefixH2OBCBS prefixH3ABCBS prefixH3BBCBS prefixH3EBCBS prefixH3IBCBS prefixH3LBCBS prefixH3PBCBS prefixH3QBCBS prefixH4FBCBS prefixH4JBCBS prefixH4KBCBS prefixH4LBCBS prefixH6UBCBS prefixH8JBCBS prefixHFHBCBS prefixHFZBCBS prefixHGVBCBS prefixHJBBCBS prefixHJSBCBS prefixHNVBCBS prefixHRFBCBS prefixHSRBCBS prefixHSSBCBS prefixHVJBCBS prefixHXEBCBS prefixHYRBCBS prefixI3ABCBS prefixI3CBCBS prefixI3PBCBS prefixI6SBCBS prefixIIEBCBS prefixIIJBCBS prefixIIKBCBS prefixIILBCBS prefixIIMBCBS prefixJ2YBCBS prefixJ4CBCBS prefixJ4EBCBS prefixJ5WBCBS prefixJ6RBCBS prefixJ6WBCBS prefixJ6XBCBS prefixJ8ABCBS prefixJ8EBCBS prefixJSMBCBS prefixK2JBCBS prefixK2KBCBS prefixK2LBCBS prefixK2RBCBS prefixK2VBCBS prefixK3WBCBS prefixK8EBCBS prefixK9PBCBS prefixKDRBCBS prefixKHCBCBS prefixKMNBCBS prefixKSVBCBS prefixKTCBCBS prefixKVTBCBS prefixKWSBCBS prefixL5DBCBS prefixL6JBCBS prefixL6LBCBS prefixL6RBCBS prefixL6TBCBS prefixL6YBCBS prefixLDNBCBS prefixLHJBCBS prefixLLRBCBS prefixLVHBCBS prefixLVLBCBS prefixLVOBCBS prefixM4ABCBS prefixM4JBCBS prefixM4LBCBS prefixMHCBCBS prefixMLEBCBS prefixMLGBCBS prefixMPEBCBS prefixMQRBCBS prefixMVRBCBS prefixN2QBCBS prefixN8EBCBS prefixODQBCBS prefixOEUBCBS prefixOEVBCBS prefixOPBBCBS prefixP2BBCBS prefixP3BBCBS prefixP3FBCBS prefixP5FBCBS prefixP6NBCBS prefixP7LBCBS prefixP7NBCBS prefixP7TBCBS prefixPCTBCBS prefixPFABCBS prefixPHZBCBS prefixPKNBCBS prefixPSGBCBS prefixQ8CBCBS prefixQDNBCBS prefixQDRBCBS prefixQLSBCBS prefixQMVBCBS prefixQZABCBS prefixR2ABCBS prefixR8NBCBS prefixR8VBCBS prefixRAFBCBS prefixRAGBCBS prefixREBBCBS prefixRELBCBS prefixREUBCBS prefixRFSBCBS prefixRGPBCBS prefixRHTBCBS prefixRIHBCBS prefixRIRBCBS prefixRJRBCBS prefixRKKBCBS prefixRKPBCBS prefixRLRBCBS prefixRNEBCBS prefixRPEBCBS prefixRPIBCBS prefixRPJBCBS prefixRRABCBS prefixRRFBCBS prefixS3NBCBS prefixS3RBCBS prefixS8YBCBS prefixSBHBCBS prefixSBJBCBS prefixSBRBCBS prefixSBTBCBS prefixSGSBCBS prefixSJEBCBS prefixSJYBCBS prefixSMZBCBS prefixSQSBCBS prefixSWRBCBS prefixT2IBCBS prefixT3BBCBS prefixT3DBCBS prefixT3FBCBS prefixT3JBCBS prefixT6QBCBS prefixT6YBCBS prefixT9UBCBS prefixTAABCBS prefixTALBCBS prefixTBKBCBS prefixTCUBCBS prefixTDCBCBS prefixTDRBCBS prefixTESBCBS prefixTHPBCBS prefixTQGBCBS prefixTRZBCBS prefixTZGBCBS prefixU3DBCBS prefixU3EBCBS prefixU3FBCBS prefixU3GBCBS prefixU5CBCBS prefixU5FBCBS prefixU5MBCBS prefixU8BBCBS prefixU9CBCBS prefixUDMBCBS prefixUGLBCBS prefixUHRBCBS prefixUJSBCBS prefixURQBCBS prefixUZEBCBS prefixV5EBCBS prefixV5SBCBS prefixW2VBCBS prefixW2XBCBS prefixW2YBCBS prefixW2ZBCBS prefixW3ABCBS prefixW3LBCBS prefixW3YBCBS prefixWDCBCBS prefixWFABCBS prefixWVTBCBS prefixX2JBCBS prefixY6HBCBS prefixYOVBCBS prefixZ2LBCBS prefixZABBCBS prefixZAHBCBS prefixZAIBCBS prefixZAJBCBS prefixZAKBCBS prefixZALBCBS prefixZAMBCBS prefixZANBCBS prefixZAQBCBS prefixZARBCBS prefixZMHBCBS prefixZODBCBS prefixZOGBCBS prefixZOIBCBS prefixZOJBCBS prefixZOKBCBS prefixZQNBCBS prefix
2027 maternity billing research
When does Highmark of Pennsylvania change OB/GYN billing?
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing its policies, procedures, and systems. This notice gives no Highmark-specific claim-submission rules or payer billing implementation date.
- Transition start
- Not published
- Billing start
- Not published
- Published
- 2026-07-01
- Current As Of
- August 2026
Scope: General maternity-services awareness notice associated with the Pennsylvania Highmark regional brands shown on the provider site. Individual products are not enumerated; Dental and Vision policies are not addressed.
Maternity billing changes for 2027. Verify the payer source before claim submission.
Frequently asked questions
Highmark of Pennsylvania payer FAQs
How do I check claim status with Highmark of Pennsylvania?
Providers check Highmark of Pennsylvania via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Highmark of Pennsylvania portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Highmark of Pennsylvania?
The primary payer ID for Highmark of Pennsylvania is 54771. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Highmark of Pennsylvania?
The provider portal for Highmark of Pennsylvania is https://apps.availity.com/. Available features depend on the payer and your account.
What is the 837P payer ID for Highmark of Pennsylvania?
The 837P payer ID for Highmark of Pennsylvania is 54771 via Stedi.
What is the 835 payer ID for Highmark of Pennsylvania?
The 835 payer ID for Highmark of Pennsylvania is 54771 via Stedi.
What is the 270 payer ID for Highmark of Pennsylvania?
The 270 payer IDs for Highmark of Pennsylvania are 54771 via Stedi and 54771 via Availity.
What is the 276 payer ID for Highmark of Pennsylvania?
The 276 payer IDs for Highmark of Pennsylvania are 54771 via Stedi and 54771 via Availity.
What state does Highmark of Pennsylvania operate in?
Highmark of Pennsylvania operates in PA.
Routing reference
Highmark of Pennsylvania payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Highmark of PennsylvaniaSource: Substrate payer directory · last refreshed |
|---|---|
| Operating states | PASource: Substrate payer directory · last refreshed |
| 837P professional claims payer IDStedi | 54771Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 54771Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 54771Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 54771Enrollment requiredSource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 54771Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 54771Enrollment requiredSource: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .
- Stedi payer catalogMatched by payer ID; matched record: Highmark of Pennsylvania. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: HIGHMARK BCBS PENNSYLVANIA PROFESSIONAL. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Highmark of Pennsylvania. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Highmark of Pennsylvania phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Payer phone
- (800) 327-6716HIGHMARK OF PENNSYLVANIA
- Payer fax
(888) 282-1321HIGHMARK OF PENNSYLVANIA
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
fax(888) 282-1321 |
| ||
| phone(800) 321-0935 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(800) 441-9188 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Hospital, Hospital - Inpatient |
| phone(800) 987-8357 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(833) 958-2804 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(800) 305-4271 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(866) 470-6244 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(484) 862-3506 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 344-5245 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 424-8270 | Other stated contextBenefit context: Coverage Basis |
| |
| phone(800) 452-8507 | Other stated contextBenefit context: Active - Pending Investigation; Benefit context: Active Coverage |
| Hospital |
| phone(800) 480-6658 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 664-2583 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 550-3733 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(866) 803-8002 | Other stated contextBenefit context: Coverage Basis |
| |
| phone(800) 327-6716 |
| ||
| phone(800) 676-2583 |
|
Phone and fax numbers sourced directly from the payer response