Our Physical Medicine program includes an authorization process for interventional pain management, arthroscopy and joint replacement. Our goal is to partner with impacted providers to help our members prepare for procedures, navigate the health care system and engage in their care.
View members who are included and excluded from this program.
Please note the following:
- All pain management, arthroscopy and joint replacement CPT/HCPCS codes indicated on our Commercial Pre-authorization List and Medicare Advantage Pre-authorization List in the Physical Medicine section for pain management or joint management require pre-authorization through eviCore healthcare (eviCore) for all members who participate in the program.
- Failure to secure authorization approval for these services through eviCore will result in claim non-payment and provider write-off.