We’re changing categorization process for physical therapy

We’re changing the categorization process for physical therapy. Beginning in January 2020, physical therapists will be assigned to one category — A, B or C — for all four networks: Blue Cross Blue Shield of Michigan, Medicare Plus Blue^SM, Blue Care Network and BCN Advantage^SM. Categories are based on the physical therapy paid claims data for all four networks.

We hope that having one assigned category covering all Blue Cross and BCN networks will make it easier for you to manage therapy requests.

The categorization process will be completed by eviCore healthcare, an independent company. They’ll also continue to generate the Provider Performance Summaries, or profile reports, and post them on the eviCore website.

Due to the upcoming changes in the categorization process, you won’t be receiving profile reports that were originally scheduled for July 2019 for Blue Cross and for November 2019 for BCN. You’ll maintain your current provider categories and current program requirements until you receive the new combined categories.

The new combined categorizations will be sent by eviCore in February 2020. You’ll still have 15 days from receipt of your categorization report to request reconsideration if you have additional information not captured in the claims data. Going forward, the combined profile reports will be available in February and August, with notifications from eviCore going out to providers in late January and July.

We’ll include more detailed information about the categorization merger in the upcoming months.