Blue Cross Blue Shield of Michigan and BCN physical therapy coverage: prior authorization
By Javier Alvarez · Updated · 1 min read
1 row: Blue Cross Blue Shield of Michigan / Blue Care Network · Michigan. Public policy, not the member's benefits.
Blue Cross Blue Shield of Michigan and BCN
BCBSM / BCN PT, OT, ST and physical medicine utilization management (revised June 2026) · Michigan
| Where it applies | The eviCore program in this document applies to BCN commercial and BCN Advantage. For other plans the document points to separate prior authorization requirements and the provider portal for details. [1] |
|---|---|
| Prior authorization | EviCore by Evernorth decides prior authorization for PT and OT for BCN commercial (all fully insured groups, all self-funded groups and all individual members) and BCN Advantage (all groups and members). [1] |
| Also | Blue Cross and BCN commercial self-funded groups can buy the Hinge Health virtual exercise therapy program: 12 visits a year with a Hinge PT, no referral or prior authorization, and it does not count toward in-person benefit limits. [1] |
What Blue Cross Blue Shield of Michigan and BCN's documents say
The table above has every field we found for Blue Cross Blue Shield of Michigan and BCN, with numbered sources. In short:
- Prior authorization. EviCore by Evernorth decides prior authorization for PT and OT for BCN commercial (all fully insured groups, all self-funded groups and all individual members) and BCN Advantage (all groups and members).
- Where it applies. The eviCore program in this document applies to BCN commercial and BCN Advantage. For other plans the document points to separate prior authorization requirements and the provider portal for details.
Other physical therapy rows for Michigan
Check Blue Cross Blue Shield of Michigan and BCN's claim against the row
Before the claim goes out, compare it with the row above: the evaluation code matches the complexity you documented, the timed codes fit the minutes, any prior authorization covers the visit, and the plan of care is signed when the payer asks for it. The physical therapy table compares Blue Cross Blue Shield of Michigan / Blue Care Network with every other payer we checked.