Special notice: Important policy changes

Mar. 2025Important Notices

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

  • Brachytherapy-MP.220 is being retired and will be replaced by Brachytherapy-MP.PA.139.
  • Implantable Loop Recorder (Subcutaneous) Cardiac Rhythm Monitor – MP.165 is being retired and will be replaced by Implantable Loop Recorder (Subcutaneous) Cardiac Rhythm Monitor – MP.PA.140.

  • Radiation Therapy, External Beam (EBRT) and Intensity-Modulated (IMRT) – MP.034 is being retired and will be replaced with Radiation Therapy, External Beam (EBRT) and Intensity-Modulated (IMRT) – MP.PA.142.

  • Radiation Therapy - SRS and SBRT – MP.060 is being retired and will be replaced with Radiation Therapy - SRS and SBRT – MP.PA.143.

  • Sleep Medicine – Sleep Study – MP.157 is being retired and will be replaced with Sleep Medicine – Sleep Study – MP.PA.144.

Again, prior authorization will be required for all of the new policies beginning May 1.

If you have any questions or concerns about these policy changes, please contact your physician account executive or call Provider Services at 1-866-918-1595.

Thank you for the excellent care and support you provide to our members.

Recent Announcements

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

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

2025 Preventative Care Rewards Program

We’re excited to continue our preventive care rewards program in 2025. This program allows eligible UPMC for Life patients to earn rewards when they complete certain preventive services, such as an annual wellness visit, a breast cancer screening, a colorectal cancer screening, or a diabetic retinal eye exam (for members with diabetes only).
Feb. 2025What's New