Understanding MP.PA.147

Jul. 2025Important Notices

Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policy

Effective date July 1, 2025 , the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policy contains clarifications in key areas:

Prior authorizations. As of July 1, 2025 MP.PA.147 now requires prior authorization for many codes across all lines of business. It is important to note that this policy applies only to diagnostic and surveillance colonoscopies, as screening exams are outside the scope of MP.PA.147.

Billing. MP.PA.147’s coding section clarifies how providers must bill the codes to denote a screening exam. The provider is responsible for clinical decisions and billing. For information on using modifier 33 and modifier PT for screening colonoscopies, please review the Colorectal Cancer Screening Billing Guide.

Learn more about MP.PA.147

Review the complete MP.PA.147 bulletin

Read the article in the July Provider Partner Update


Recent Announcements

Medicaid Renewal

Starting in 2027, some Medicaid recipients (ages 19–-64) will have new requirements to keep their coverage.
Aug. 2026Important Notices

Provider Directory Updates and Required Attestation

As you know, UPMC Health Plan requires all providers to verify their provider directory information at least every 90 days (quarterly).
Aug. 2026Important Notices

Voluntary nationwide recall: Tyenne (Fresenius – August 2026)

Fresenius Kabi is recalling one lot, lot 16UI07, of Tyenne® (tocilizumab-aazg) Injection 400 mg/20 mL (20 mg/mL) 20 mL vials. Tyenne is used for the treatment of certain arthritis conditions.
Aug. 2026Pharmacy Updates