Massage Therapy Utilization Review Ends January 1, 2027

EviCore Healthcare (EviCore) will no longer perform utilization review for massage therapy services beginning January 1, 2027. EviCore will continue managing utilization review for other outpatient rehabilitation services, such as physical therapy and occupational therapy.

How it Works

Massage therapy services will continue to be determined by plan benefits, visit limits, and coverage provisions. Providers should continue verifying eligibility, benefits, and any applicable limitations before providing services.

Claims and Appeals

This change does not affect member cost sharing, deductibles, copayments, coinsurance, reimbursement rates, or benefit limits. Massage therapists should keep a prescription on file to show medical necessity if requested.

Next Steps

After January 1, 2027, appeals for prior massage therapy denials should be sent to LifeWise Health Plan of Washington instead of EviCore.