| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Rarely Utilized Radiation and Oncology Procedures | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Miscellaneous Services | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Endoscopic Radiofrequency Ablation/Cryotherapy | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Per-Oral Endoscopic Myotomy | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Evinacumab-dgnb (Evkeeza) | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Oncologic Indications for Histone Deacetylase (HDAC) Inhibitors | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Golimumab (Simponi, Simponi Aria) | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Glofitamab-gxbm (Columvi) | 2025-12-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Human Growth Hormone | 2025-12-01 |
| BCBS Highmark Penn Medicare Advantage | Glofitamab-gxbm (Columvi) | 2025-12-01 |