PA Medicaid Provider Guidelines


For our Pennsylvania providers, we've developed a set of guidelines for a variety of conditions, as well as clinical indicators and reference materials.



This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 14 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

Not a Provider?

Join our network and help us provide the best health coverage around.

Sign Up

Copyright 2023 by Highmark WholecareSM