Outpatient PT, OT services no longer require prior authorization for Medicare Plus Blue^SM, starting April 1

For dates of service on or after April 1, 2022, Medicare Plus Blue will no longer require prior authorization for outpatient physical and occupational therapy services. You can submit retroactive authorization requests to eviCore healthcare^®* through July 29, 2022, for dates of service prior to April 1, 2022.

We’ll update the Medicare Plus Blue PPO Provider Manual and other documents to reflect this change.

These services will be managed by a network performance management company later this year. We'll publish a provider alert and an article in The Record in the near future with more details.

*eviCore healthcare is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage authorizations for select services. For more information, go to our ereferrals.bcbsm.com website.

Posted: March 2022
Line of business: Blue Cross Blue Shield of Michigan