UPMC Health Plan Timely Filing Limit

Coverage: UPMC product-specific provider manual billing guidance, updated August 25, 2025.

UPMC Health Plan filing guidance from the reviewed sources: UPMC Community HealthChoices, for Kids (CHIP), and for You Medical Assistance: 180 calendar days from service. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• The manual lists different filing periods by UPMC product, not one plan-wide limit.

Initial claim filing limits

• UPMC Community HealthChoices, for Kids (CHIP), and for You Medical Assistance: 180 calendar days from service.
• UPMC for You EPSDT: 90 calendar days from service.
• UPMC for Life, Pitt retirees, Complete Care D-SNP, and listed commercial/FEHB/PSBH products: 365 calendar days from service.

Corrected claim filing limits

• Not clearly published in the researched sources.

Appeal and reconsideration deadlines

• Not clearly published in the researched sources.

Trigger basis and caveats

• Confirm current product and provider agreement. The manual is a 2025 source; do not treat an unpaid-claim follow-up interval as a filing limit.
• Rejected claims are new submissions; denied claims are corrected submissions. Both must meet the applicable filing period.

Provider resources

• Official provider policy or review source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Retained product distinctions and rejection-versus-denial instructions. Contract and current manual confirmation remain required.