Special notice: Important policy changes

Effective June 1, 2025, UPMC Health Plan will be implementing policy changes that will require providers to obtain prior authorizations for services listed in the following policies. For more information, please visit upmchp.us/policiesandprocedures.

• Varicose Veins – MP.066 is being retired and will be replaced by Varicose Veins – MP.PA.145.

• Genetic Testing – Hereditary and Multifactorial Diseases – MP.PA.118 is a new prior authorization policy.

   

• Laparoscopic Cholecystectomy, 18 Years Old and Older – MP.PA.146 is a new prior authorization policy.

   

• Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 is a new prior authorization policy.

   

• Cardiac Ablation Procedures, 18 Years Old and Older – MP.PA.148 is a new prior authorization policy.

Again, prior authorizations will be implemented in accordance with these policies beginning June 1.

If you have any questions or concerns about these policy changes, please contact your physician account executive or call Provider Services at 1-866-918-1595.

Thank you for the excellent care and support you provide to our members.