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.