Pennsylvania
UPMC Health Plan fee schedule 2026, by CPT code.
UPMC Health Plan publishes the rate it negotiated with each practice it contracts with, by NPI. Enter yours and we read UPMC Health Plan’s files for your rates.
What you’ll get
| Code | Visit | Your UPMC Health Plan rate | Source file |
|---|---|---|---|
| Filled in from UPMC Health Plan’s own file when you enter your NPI. | |||
UPMC Health Plan publishes 8 in-network rate files. We read them for the rate listed for your practice, code by code.
Need the codes you bill, across your payers? Start a fee schedule from $99/month.
Inside UPMC Health Plan’s files
What UPMC Health Plan publishes.
Published by UPMC Health Plan under the federal Transparency in Coverage rule.
What you get
The number, and everything behind it.
The exact dollar UPMC Health Plan negotiated for a CPT code and your NPI — the genuinely negotiated figure, chosen by a fixed rule, not the “derived” line beside it.
Which UPMC Health Plan network the rate sits in (an HMO and a PPO product can pay differently), and that it’s the in-office professional rate.
The source file and its “as of” month, linked — so the number survives being questioned by a contracting manager.
On a paid plan, UPMC Health Plan becomes one column of a sheet next to every other payer you take, with underpayment checks and change alerts.
After the rate
Is UPMC Health Plan paying you what it published?
Upload your allowed amounts by code and see which ones UPMC Health Plan allowed below the rate it published for you, the claims affected and the dollar gap. Totals only, no patient data. →
Fee scheduleUPMC Health Plan next to every other payer you take, code by code, in one sheet, with the source behind every number and an alert when a rate changes. →
Also in Pennsylvania
The other payers we read here.
Your state
All the payers we read in Pennsylvania.
Questions about UPMC Health Plan’s rates or your contract? Ask us →