April 2020

Physical Medicine Utilization Management Program: 2020 Group Number Updates

Blue Cross and Blue Shield of Illinois (BCBSIL) has a PPO utilization management (UM) program for outpatient physical medicine, which includes physical therapy, occupational therapy and chiropractic services. This program is part of our commitment to help our members get the right care at the right time and place.

This physical medicine UM program has been in place for City of Chicago PPO members for several years. It was expanded as of Jan. 1, 2017, to include chiropractic services for Indian Prairie School District PPO members. Effective April. 1, 2020, the following is a revised list of group numbers included in the program:

*These group numbers have been added effective April 1, 2020.

Refer to the Related Resources in the Prior Authorization section of our website for more information, such as the Physical Medicine UM Program FAQs.

Please note that the fact that a guideline is available for any given treatment, or that a service has been preauthorized, is not a guarantee of payment. Benefits will be determined once a claim is received and will be based on, among other things, the member’s eligibility and the terms of the member’s certificate coverage applicable on the date services were rendered. If you have any questions, contact the number on the member’s ID card.