Update to Multiple Procedure Payment Reduction reimbursement

Oct. 2024Important Notices

We previously communicated to both contracted physicians and facilities that UPMC Health Plan will begin applying Multiple Procedure Payment Reduction (MPPR) on certain diagnostic imaging services for Commercial, Medicare and Medicaid lines of business, with contracts based on a percentage of Medicare APC or % billed charges excluded.

There are modifications to this change, as only professional claims will be affected. This implementation will not affect facility claims. Additionally, this application will not include Medicaid line of business claims as previously noted. If you have any questions, please contact your physician account executive or call Provider Services at 1-866-918-1595.


Recent Announcements

HPV Vaccination Resources

To help protect against cancers later in life, it is important to increase HPV vaccination rates in adolescents starting at age 9. According to the Centers for Disease Control and Prevention, HPV vaccination is routinely recommended at age 11 or 12, but the vaccine can be given starting at age 9.1 The Pennsylvania Cancer Coalition cites the following potential benefits of initiating the HPV vaccine series at age 9:2
Mar. 2025Important Notices

Special notice: Important policy changes

Effective May 1, 2025, the following policies will be retired and replaced with prior authorization policies. For more information, please visit upmchp.us/policiesandprocedures.
Mar. 2025Important Notices

CME Webinar: Essential Best Practices for Newborn Care: Ensuring Healthy Beginnings Through Comprehensive Care

Please join us for a live, CME-accredited webinar on Wednesday, May 7, from noon to 1 p.m. that will provide an overview of newborn care.
Feb. 2025Education/Webinars