How to Submit a Superbill to Highmark for Therapy Reimbursement

Highmark Out-of-Network Process

Highmark BlueCross BlueShield serves members in Pennsylvania, Delaware, and West Virginia. Members submit OON mental health claims via the Highmark member portal at highmark.com or by mailing a paper claim form with the superbill attached. Highmark's behavioral health is administered through Highmark Behavioral Health or via an external vendor — the correct claims address is printed on the member's insurance card.

Common Denial Reasons

• ✗Provider is licensed outside Pennsylvania, Delaware, or West Virginia — verify license state
• ✗Claim submitted to Highmark's medical department rather than behavioral health department
• ✗Member enrolled in a Highmark HMO plan that excludes OON mental health coverage
• ✗Missing taxonomy code on the superbill — Highmark requires provider specialty identification

Tips for Getting Reimbursed by Highmark

• ✓Verify the behavioral health claims address on the member's card — it often differs from the medical claims address
• ✓Highmark PPO members generally have stronger OON mental health benefits than HMO members
• ✓Include your NPI, taxonomy code, and state license number on every superbill for Highmark claims
• ✓Highmark offers a pre-service review process — clients can get an estimate of OON reimbursement before starting care