Providence Health Plan Resources
Providence Health Plan is pleased to announce its partnership with eviCore healthcare to provide Physical and Occupational Therapy benefits management services for members enrolled in select Commercial Plans.
Providence Health Plan is expanding its partnership with eviCore healthcare for Physical Medicine benefits management services. As part of these efforts, several of our Self-Funded (Administrative Services Only) group plans will become effective with requiring eviCore medical necessity reviews as of January 1st, 2023 for the following codes:
- Outpatient rehabilitation Physical therapy
- Outpatient rehabilitation Occupational therapy
- Chiropractic (Please Note: Procedure codes 98940, 98941, 98942, and 98943 are not part of this program)
- Massage Therapy (Please Note: Procedure code 97124 is not part of this program)
- Acupuncture (Please Note: Procedure codes 97810, 97811, 97813 and 97814 are not part of this program)
Please visit the Providence Health Plan website to view a full list of group plans.
Please go to the above “General Resources” tab and click on “Provider Orientation Invitation”
for instructions on how to register for an upcoming Providence Health Plan Physical Medicine Orientation.
eviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.