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
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
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
Important updates on influenza prevention and treatment
As we continue to navigate flu season, we want to emphasize three critical areas to ensure the health and safety of your patients who are UPMC Health Plan members: Consider antiviral therapy when appropriate, encourage masking to prevent the spread of respiratory viruses, and continue to recommend the flu vaccine.Feb. 2025Important Notices