Introduction of Window Period into Chiropractic Pilot Program

December 2017

Effective January 1, 2018, WSI will implement a change to the chiropractic pilot program.  The pilot program currently requires a chiropractor to obtain authorization for all chiropractic treatment extending beyond the initial office visit.  Based on preliminary data and provider feedback, WSI will alter the program to include a window period.

WSI defines the window period as a period of initial chiropractic treatment on a claim not requiring prior authorization.  For initial treatment with a date of service on or after January 1, 2018, each claim will have one window period, which will include:

  • 6 visits or 60 days of care, whichever comes first, including initial evaluation
  • Treatment of all body parts accepted on a claim
  • Up to two modalities per visit

For treatment occurring outside the window period, a chiropractor will need to complete the Utilization Review Chiropractic (UR-Chiro) form.  This includes treatment initiated prior to January 1, 2018, treatment extending beyond the window period and palliative care.

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