UPMC

aid: upmc
url: https://raw.githubusercontent.com/api-evangelist/upmc/refs/heads/main/apis.yml
name: UPMC
type: Index
image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg
tags:
  - Healthcare
  - Health Insurance
  - Hospitals
  - Pennsylvania
  - FHIR
description: 'A world-renowned health care provider and insurer headquartered in Pittsburgh, Pennsylvania. One of the largest nonprofit health systems in the United States, operating hospitals, physician practices, and a health insurance division (UPMC Health Plan) serving millions of members. UPMC Health Plan exposes an ONC 21st Century Cures Act Developer API for patient-authorized access to clinical and claims data over HL7 FHIR.'
created: '2026-05-05'
modified: '2026-05-16'
specificationVersion: '0.19'
apis:
  - aid: upmc:cures-act-developer-api
    name: UPMC Health Plan ONC 21st Century Cures Act Developer API
    tags:
      - FHIR
      - Patient Access
      - Healthcare
      - Health Insurance
      - Cures Act
      - HL7
    image: https://kinlane-productions2.s3.amazonaws.com/apis-json/apis-json-logo.jpg
    humanURL: https://www.upmchealthplan.com/
    properties:
      - url: https://www.upmchealthplan.com/
        type: Documentation
    description: >-
      The UPMC Health Plan Developer API is the payer-side FHIR API mandated
      by the ONC 21st Century Cures Act and the CMS Interoperability and
      Patient Access Final Rule. It allows registered third-party applications
      to retrieve a member's clinical (USCDI) and claims data on the member's
      behalf using SMART-on-FHIR / OAuth 2.0 authorization. The API surface
      includes the Patient Access API (clinical + claims) and the Provider
      Directory API. UPMC Health Plan exposes a public link to the developer
      API resource center in the footer of every page on upmchealthplan.com.
common:
  - type: GitHubOrganization
    url: https://github.com/UPMC
  - type: LinkedIn
    url: https://www.linkedin.com/company/upmc
  - type: Website
    url: https://www.upmc.com/
  - type: Website
    url: https://www.upmchealthplan.com/
  - type: Documentation
    url: https://www.upmchealthplan.com/
  - type: Features
    data:
      - name: Patient Access FHIR API
        description: Member-authorized access to clinical (USCDI) and claims data per CMS Interoperability and Patient Access Final Rule
      - name: Provider Directory API
        description: Public machine-readable provider directory required by CMS Interoperability rules
      - name: SMART-on-FHIR Authorization
        description: OAuth 2.0 / SMART-on-FHIR app authorization flow for patient-mediated access
      - name: HL7 FHIR R4 Data Model
        description: USCDI-aligned FHIR R4 resources for clinical and claims data exchange
  - type: UseCases
    data:
      - name: Patient Data Portability
        description: Members move their clinical and claims data into third-party apps for personal use
      - name: Care Coordination
        description: Authorized clinical applications retrieve member records to improve care coordination across providers
      - name: Health Apps and PHRs
        description: Consumer-facing personal health record and wellness apps connect to UPMC member data with patient consent
      - name: Provider Directory Lookups
        description: Apps and portals discover in-network UPMC Health Plan providers through the public provider directory API
  - type: Integrations
    data:
      - name: SMART App Launch
        description: Apps register with UPMC Health Plan as SMART-on-FHIR clients to authenticate members
      - name: USCDI Clinical Data
        description: USCDI-aligned clinical resources flow to member-authorized third-party applications