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, effective with dates of service of Sept. 1, 2012, and beyond.

Learn More About the Physical Medicine Management Program

Communications:

Please continue to look for future communications from us on this topic, and check the Plan Central page of NaviNet, Today’s Messages on the Provider Resource Center and upcoming issues of Provider News for additional tools and information to assist you in the program's authorization process.

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

Education

The training module below includes audio. Please ensure that your speakers are adjusted accordingly.

Advisory Committee Meeting Minutes

Last updated on 6/28/2019

 

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