Additional procedure codes payable to chiropractors for physical therapy services

Additional procedure codes** are payable to chiropractors for physical therapy services, effective Aug. 1, 2015. This change applies to groups with standard chiropractic benefits.

Due to this change, starting Aug. 1, physicians may be asked to agree to and sign a physical therapy treatment plans developed by chiropractors. A prescription is not required for a member to receive covered physical therapy benefits from a chiropractor.

This provision means only that Blue Cross Blue Shield of Michigan will pay for the first physical therapy service per patient and not per visit.  After the first physical therapy service is provided, Blue Cross will not pay for additional physical therapy services to the patient without the development of a PT plan that is agreed to and signed by the M.D. or D.O.  The only exception to this requirement is for mechanical traction (physical therapy code *97012), which may be performed at subsequent visits without a PT plan.

Regarding mechanical traction, Blue Cross will maintain the current payment structure.  A physical therapy treatment plan is not required for this code. Providers are asked to document the use of the code in the PT plan if it is performed in addition to other physical therapy services.  This will allow the M.D. or D.O.  to be aware of all of the treatment the patient is receiving and ensure coordination and quality of care.

Note: No physician agreement or signature is required on a treatment plan for MESSA members.

**Check the billing chart in this issue of The Record for the specific codes now payable to a chiropractor.