For Providers

Information for UPMC Community HealthChoices Providers

Community HealthChoices (CHC) is the Department of Human Services’ (DHS) Medical Assistance (Medicaid) program that allows managed care organizations (MCOs) to coordinate medical care and long-term services and supports (LTSS) for individuals who qualify for Medical Assistance and also qualify for Medicare or require a nursing facility level of care.

UPMC Community HealthChoices is one of three CHC-MCOs selected by the state to provide this program.

Community HealthChoices program availability and participant service areas:

January 1, 2018
Southwestern Pennsylvania counties:
Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland.

January 1, 2019
Southeastern Pennsylvania counties:
Bucks, Chester, Delaware, Montgomery, and Philadelphia

January 1, 2020
All other Pennsylvania counties


FOR MEDICAL PROVIDERS

UPMC Community HealthChoices includes all medical benefits covered by DHS' Medical Assistance adult benefit package and replaces fee-for-service Medical Assistance for dual eligible participants. Check out our medical provider's page for more information.

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FOR NONMEDICAL PROVIDERS

UPMC Community HealthChoices includes all home and community based services (HCBS) covered by the DHS-approved 1915(c) waiver. Our HCBS provider's page has more information.

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FREQUENTLY ASKED QUESTIONS

Do you have questions about Community HealthChoices? Please visit our FAQ section. If you have further questions, please call UPMC Community HealthChoices Provider Services Monday through Friday, 8 a.m. to 5 p.m. at 1-844-860-9303.

Get Answers to Frequently Asked Questions
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