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March 29, 2022

We are sunsetting preauthorization (PA) requirements on chiropractic, acupuncture and massage (CAM) treatments for fully insured groups effective April 1, 2022. PA will no longer be required for group members on most CAM services delivered April 1, 2022, or later. Currently, providers submit PA requests for CAM services to eviCore.

The CAM PA buy-up option for self-funded groups is being discontinued. For self-funded groups that currently have the buy-up option for 2022, the program will continue until their next renewal. Please don’t quote the program for renewals with effective dates beginning April 1, 2022, or for any new groups, as it will not be available.

PA will still be required for CAM services occurring through March 31, 2022, and for members of self-funded groups that have purchased our Physical Medicine program with the CAM component.

Eliminating PA requirements on CAM will have no impact on 2022 rates. There are no changes to PA requirements for physical therapy, occupational therapy and speech therapy. We’ll still use eviCore for PA for these services for fully insured groups and as a buy-up option for self-funded groups.

Have questions? Please contact your account executive.