CommercialPrior AuthMedium impact
Important Notice Regarding Prior Authorizations for MP.PA.147
UPMC Health Plan·Gastroenterology, General Surgery, Family Medicine +1 more·Prior Authorization
Effective date
Sep 1, 2025
We identified it
Jun 20, 2026
Summary
UPMC Health Plan has paused the prior authorization requirement for diagnostic and surveillance colonoscopy procedures (policy MP.PA.147) that was originally set to begin June 1, 2025. The prior auth requirement is now delayed until September 1, 2025, and any authorizations already submitted will be processed without review.
Action Required
Before September 1, 2025: Billing team should update systems and workflows to prepare for prior authorization requirements for diagnostic and surveillance colonoscopy procedures under UPMC Health Plan policy MP.PA.147. Monitor for additional updates from UPMC regarding specific CPT codes and documentation requirements as the September 1st effective date approaches.