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Outpatient Physical Therapy Update & Change

Effective March 1, 2016, outpatient physical therapy benefits will be administered by the TheraMatrix Physical Therapy Network (TPTN). TPTN provides comprehensive outpatient physical therapy services through its nationwide network. These sites have been carefully selected for quality and member access.

This means that your outpatient physical therapy coverage will no longer be provided by your SCN or PPO medical carrier (Blue Cross Blue Shield, United HealthCare or Medical Mutual of Ohio).

In-Network Benefit Level
Outpatient physical therapy services provided by TPTN participating providers are covered when services are medically necessary and prior authorized.
  • Your coverage allows for up to 60 visits per condition, per calendar year. The 60-visit limit is combined with physical, functional occupational, and speech therapy.
  • You are encouraged to choose an in-network provider to avoid out-of-pocket expenses.
  • To identify an in-network provider for newly prescribed physical therapy services, you can:
    • Contact TheraMatrix at 1-888-638-8786 or
    • Visit Click on “Location Finder” to view provider locations. There are thousands of national participating providers should you or your family members (such as a college student) need services away from home.
Out-of-Network Benefit Level
Outpatient physical therapy services provided by non-participating providers are not covered and you will not be reimbursed for any charges incurred.
  • If there is not an in-network participating provider within a 25-mile radius of your home, prior to receiving services, contact TheraMatrix at 1-888-638-8786 and we will establish arrangements with a physical therapy provider in your area.
  • Please be advised that you are responsible for contacting TPTN to ensure that prior arrangements are made; otherwise the services will not be covered and you will be responsible for all charges.
Transitioning Current Physical Therapy Services
If you are currently receiving outpatient physical therapy services:
  • Contact TheraMatrix at 1-888-638-8786 to verify your provider’s participation status.
  • If you are using an out-of-network provider, you may complete your current prescription. Thereafter, you must access any additional services through TPTN to minimize any out-of-pocket costs to you.
Identification (ID) Card
You will not receive a separate ID card. You may cut out the information card below and keep it with your medical ID cards for future reference.
TheraMatrix Benefits
The BCBS insurance card will still be used and if a member is currently receiving outpatient physical therapy they can complete their current prescription.
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