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
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.May 2025Important Notices
Provider OnLine Enhancements
Provider OnLine will be launching enhancements to the authorization process on April 18, 2025. The enhancement will include the following updates:Apr. 2025Important Notices
Fostering Trust in Vaccinations Through Shared Decision Making
Please join us for a live, CME-accredited webinar on Wednesday, June 4, from noon to 1 p.m. that will provide an overview of fostering trust in vaccinations through shared decision making.Apr. 2025Education/Webinars