New implementation date for Skilled Nursing and Personal Care Shift Services & MA & MP.PA.050.1

Jul. 2023Important Notices
We previously communicated in the July Provider Partner Update that effective Aug. 1, 2023, per Pennsylvania DHS, HCPCS T1019 will be discontinued and replaced with the following HCPCS codes and modifiers:
  • G0156 with modifier U7 for pediatric aide services by a non-legally responsible relative
  • G0156 with modifiers U7/SC for pediatric aide services by a legally responsible relative
  • G0156 U7 TT – Services of home health/hospice aide in home health or hospice settings, each 15 minutes (services by a non-legally responsible relative) – extra patient
  • G0156 U7 SC TT – Services of home health/hospice aide in home health or hospice settings, each 15 minutes (services by a legally responsible relative) – extra patient

Please be aware that due to an additional and more recent communication from PA DHS, the implementation date was changed to Oct. 1, 2023 (previously communicated in the July PPU as Aug. 1, 2023).

Recent Announcements

Voluntary nationwide recall: Ocaliva (Intercept – September)

Intercept Pharmaceuticals, Inc. is voluntarily withdrawing Ocaliva® (obeticholic acid) from the market. Ocaliva is used to treat a rare liver disease called primary biliary cholangitis (PBC).
Oct. 2025Pharmacy Updates

HelpScript service helps patients enroll in manufacturer copay assistance programs

End-to-end provider support helps ensure a smooth submission process
Oct. 2025Important Notices

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