Home health telehealth update

May 2022Important Notices
"As you know, home health services have been approved for coverage via telehealth since the onset of the COVID-19 pandemic. Based on the usage and success of home health telehealth, UPMC Health Plan has expanded the option as a permanent telehealth service when appropriate. Effective April 1, 2022, UPMC Health Plan updated the Telehealth – MP.148 policy to include home health services as a telehealth option for members as indicated in the policy. This update is a result of a collaboration between many UPMC Health Plan departments. Services covered by the policy include observation, training or education in skilled nursing, medical social work, physical therapy, occupational therapy, speech therapy, and home health aid. A telehealth visit must include audio and video components.

Home health telehealth has successfully assisted home health agencies with current staff shortages and allows members to conveniently access services in the comfort of their home in a timely and effective manner."

Recent Announcements

Important announcement – Telehealth submissions

As of October 1, 2025, UPMC Health Plan continues to accept the submission of telehealth claims. Providers may conduct telehealth visits for UPMC Health Plan members in all UPMC Insurance products. UPMC Insurance products include UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, UPMC for Kids CHIP plans, UPMC Community HealthChoices, and UPMC for You Medical Assistance plans.
Sep. 2025Important Notices

October 2025 UPMC for You and UPMC Community HealthChoices Formulary Update

Effective October 1st, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to non-participation in the Medicaid Drug Rebate Program.
Sep. 2025Pharmacy Updates

Biosimilar Medication Formulary Updates

Updates to formulary biosimilar medications for denosumab, eculizumab, and ustekinumab products
Sep. 2025Pharmacy Updates