Direct reimbursement available to athletic trainers for physical medicine services on or after Jan. 1

Athletic trainers will have the opportunity to participate in Blue Cross Blue Shield of Michigan’s commercial networks (Traditional and TRUST), as well as BCN commercial and BCN Advantage℠, starting Jan. 1, 2021.

Participating athletic trainers will receive direct reimbursement for covered services within the scope of their licensure at 85% of the applicable fee schedule, minus any member deductibles and copayments. This change, effective for services provided on or after Jan. 1, affects Blue Cross and BCN benefit plans that cover services that these providers are licensed to provide. To find out if a patient has coverage, check web‑DENIS for member benefits and eligibility or call Provider Inquiry at 1‑800‑344‑8525.

Athletic trainers can apply for the networks starting Oct. 1, 2020. To apply, go to bcbsm.com/providers and click on Enroll to become a provider. Specific qualification requirements are identified within each agreement.

All applicants to the TRUST PPO, BCN HMO and BCN Advantage networks must pass a credentialing review before participation. We’ll notify applicants in writing of their approval status.

Authorization requests for BCN members
For BCN commercial and BCN Advantage members, athletic trainers must submit authorization requests for physical medicine services to eviCore healthcare. There is no authorization required for Blue Cross commercial members.

About PT benefits
Athletic trainers should tell members that the physical medicine services they provide count toward a member’s physical therapy benefits. Because PT benefits are limited during a plan year, the physical medicine services provided by athletic trainers will reduce a member’s future benefits for that plan year.