Physical Medicine Management Program

To help ensure that outpatient physical medicine services (physical therapy, occupational therapy and manipulation services) provided to our members are consistent with nationally recognized clinical guidelines, Highmark has contracted with WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC., to administer a registration process for physical medicine services as well as to provide medical necessity review and authorization, where applicable, for these services.

Administrative Guide

Reference Materials

The following documents/forms include information that supports the Physical Medicine Management Program; the purpose of each is fully explained in the Administrative Guide above.

Clinical Criteria

Physical/Occupational Therapy

Manipulation

Outcome Assessment Tool

Reconsiderations and Appeals

Last updated on 9/30/2022 9:43:57 AM

 

*This program began on September 1, 2012.

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