Review our commercial product billing guide
Dec. 2023Important Notices
Pennsylvania Act 1 of 2023, signed into law this May, requires insurance policies to cover all costs associated with one supplemental breast screening every year for women with increased risk of breast cancer via MRI or ultrasound.
To assist providers in navigating this new law, we are offering recommendations as a guide to aid with compliance.
We encourage you to review our commercial product billing guide for recommendations around complying with Pennsylvania Act 1 of 2023.
If you have any questions or concerns, please contact your physician account executive or call Provider Services at 1-866-918-1595.
To assist providers in navigating this new law, we are offering recommendations as a guide to aid with compliance.
We encourage you to review our commercial product billing guide for recommendations around complying with Pennsylvania Act 1 of 2023.
If you have any questions or concerns, please contact your physician account executive or call Provider Services at 1-866-918-1595.
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 productsSep. 2025Pharmacy Updates