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

Watch for a chance to rate your experience with UPMC Health Plan

Watch for a chance to rate your experience with UPMC Health Plan. You may be randomly selected to participate in a 2026 Press Ganey provider satisfaction survey that will begin this month.
Aug. 2026Important Notices

Voluntary nationwide recall: Cetirizine (Unique – July)

Unique Pharmaceutical Laboratories (A Div. of J. B. Chemicals & Pharmaceuticals Ltd.) is recalling four lots (GY825029, GY825030, GY825031, GY825032) of Cetirizine Hydrochloride Tablets USP 5 mg. Cetirizine is used for the relief of allergy symptoms, including itchy, red, watery eyes and itchy skin.
Jul. 2026Pharmacy Updates

August 2026 UPMC for You and UPMC Community HealthChoices Formulary Updates

Effective Aug. 15, 2026, UPMC for You and UPMC Community HealthChoices are updating their formularies.
Jul. 2026Pharmacy Updates