Chiropractors may provide some physical therapy services for BCN commercial members

Effective Aug. 1, 2015, chiropractors contracted with BCN may provide some physical therapy services for BCN HMO^SM (commercial) members with coverage through groups that offer standard chiropractic benefits. This applies to services represented by select *97XXX procedure codes, rendered in office and outpatient care settings.

The member's primary care physician must issue a global referral for "office visits" when the member:

• Is from the East or Southeast region


• Has a plan with a designated provider network the chiropractor does not belong to

The chiropractor may then request authorization for an episode of care directly from Landmark Healthcare, who manages these services for members on BCN's behalf.

You'll find additional information about the referral and authorization process for these services in the Care Management chapter of the BCN Provider Manual. Look in the section titled "Therapy management: PT, OT and ST (including chiropractors providing PT services)". This section has been updated to reflect the details that primary care physicians, specialists and chiropractors need to know.

The document Outpatient rehabilitation services: Frequently asked questions has also been updated with these changes.

Both documents are available through hyperlinks on the Outpatient Physical, Occupational and Speech Therapy Management Program page on this website.

* CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.