PT, OT, ST and Physical Medicine Services: Resources

Resources on the EviCore website

Follow these steps to access information about PT and OT category assignments and more on the EviCore website:

1. Go to evicore.com*
2. Click either Providers or Resources at the upper right.
3. Click the Provider Resources button.
4. Select Blue Care Network in the “Select Health Plan” field.
5. Click the Search button.
6. Click the Solution Resources tab.
7. On the Blue Care Network Provider Resources page, click the Musculoskeletal button.
8. Click the link to open the desired document.

Additional Resources

• Procedure codes for which providers must request prior authorization — See this document to determine which procedure codes require prior authorization
• Services reviewed by eviCore for Blue Cross and BCN — Outlines the types of services for which eviCore manages prior authorizations, how to submit requests, where to find clinical criteria and guidelines, and more
• Outpatient rehabilitation services: Frequently asked questions
• PT, OT and ST, and physical medicine services by chiropractors and athletic trainers: For virtual exercise therapy and prior authorization determinations — Includes information about utilization management programs
• U-M Premier Care Primary (Major) Diagnosis Codes for Therapies