Changes coming 4/15 to benefits and coverage for lower back pain

Effective April 15, 2018, we are modifying processes for low back pain to more closely align with and adhere to the Oregon Health Plan (OHP) coverage criteria specified by Guideline Note 56 from the Prioritized List of Health Services.

For services delivered after April 15, we will require that providers submit the STarT tool, or equivalent, with requests for coverage of services, including but not limited to PT/OT, acupuncture, OMT/CMT, chiropractic services, or Cognitive Behavioral Therapy (when available). All services will require prior authorization.

If you are an acupuncture provider, please click here for specific benefit changes.

For details about changes to all disciplines listed above, please read this letter from our Senior Medical Director, Doug Luther, MD.

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