CommercialCoverageHigh impact
COVID-19 PHE
UPMC Health Plan·PA·Provider Announcement
Effective date
May 11, 2023
We identified it
Aug 7, 2026
Summary
The COVID-19 public health emergency ended on May 11, 2023. UPMC Health Plan has updated Appendix A to reflect new end dates for COVID-19-specific benefits and coverage under their products. Billing teams must review Appendix A to identify which COVID-related benefits are no longer covered or have changed terms, and update billing workflows accordingly.
Action Required
By July 6, 2023: Billing team must obtain and review the updated Appendix A from UPMC Health Plan to identify all COVID-19-specific benefits with new end dates (such as telehealth waivers, testing coverage, vaccine administration, treatment drugs, etc.). Update billing system rules and denial logic to reflect which COVID-related services are no longer covered or require different billing. Audit recent claims to identify any submitted after May 11, 2023 for affected services and resubmit with corrected benefits. If clarification is needed on specific coverage changes, contact UPMC Provider Services at 1-866-918-1595. Failure to implement these changes will result in claim denials and payment delays for any COVID-related services billed after the May 11 end date.