CommercialPrior AuthMedium impact
Heart catheter authorization update
UPMC Health Plan·Cardiology, Cardiothoracic Surgery·Prior Authorization
Effective date
Sep 20, 2022
We identified it
Jun 20, 2026
Summary
Effective September 20, 2022, UPMC Health Plan eliminated prior authorization requirements for right heart catheter (CPT 93456) and left heart catheter (CPT 93452) procedures. Billing teams can now submit these procedures without obtaining prior authorization.
Action Required
Immediately: Update billing system to remove prior authorization requirements for CPT 93456 (right heart catheter) and 93452 (left heart catheter) for UPMC Health Plan members. Update encounter forms and staff training materials to reflect that these procedures no longer require prior auth. Contact UPMC Utilization Management at 1-800-425-7800 with questions.