PT, OT, ST and Physical Medicine Services

Resources

EviCore by Evernorth^® manages prior authorizations for the following services and members:

Service	Members
Physical, occupational and speech therapy by independent physical therapists, outpatient therapy providers, physician practices and hospital-based outpatient therapy centers Note: For autism-related services on or after Jan. 1, 2024, prior authorization isn’t required for members 19 years of age or older. Visit the Autism page for additional information.	Blue Care Network commercial BCN Advantage^℠
Physical medicine services by chiropractors or athletic trainers Note: For autism-related services on or after Jan. 1, 2024, prior authorization isn’t required for members 19 years of age or older. Visit the Autism page for additional information.	BCN commercial

Service

Members

Physical, occupational and speech therapy by independent physical therapists, outpatient therapy providers, physician practices and hospital-based outpatient therapy centers

Note: For autism-related services on or after Jan. 1, 2024, prior authorization isn’t required for members 19 years of age or older. Visit the Autism page for additional information.

Blue Care Network commercial
BCN Advantage^℠

Physical medicine services by chiropractors or athletic trainers

Note: For autism-related services on or after Jan. 1, 2024, prior authorization isn’t required for members 19 years of age or older. Visit the Autism page for additional information.

BCN commercial

The requirements above don’t apply to members with BCN 65 plans.

How to submit prior authorization requests

To learn how to submit requests, see our Getting Started page.

Submit requests before providing services.

Utilization Management Criteria

Visit our Utilization Management Criteria page.

EviCore by Evernorth is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.