How is acupuncture billed?

How is acupuncture billed?

Most private payors require that acupuncture services be billed using one of the following four AMA CPT codes: 97810 (acupuncture, 1 or more needles; without electrical stimulation, Initial 15 minutes of personal one-on-one contact with the patient).

What is a unit of acupuncture?

Since acupuncture services are always billed in 15-minute increments, your practice will use one code for the initial 15 minutes of service and then a separate code for additional units of time. Your acupuncture billing codes will only vary if you include electronic stimulation in your treatment.

Can a licensed acupuncturist bill Medicare?

“Currently, acupuncturists are not recognized by CMS as Medicare providers, and are not eligible to bill for acupuncture services. It is possible, however, for acupuncturists to provide acupuncture as auxiliary personnel ‘incident to’ a physician’s service in certain settings.

Does Medicare pay for 97810?

Medicare will cover up to 12 acupuncture sessions over the course of 90 days, as well as an additional eight sessions for patients who show improvement. The acupuncture CPT codes (97810-97813) are paid based on 15-minute units of time.

Does insurance cover acupuncture?

Some health insurance plans cover acupuncture. But the good news is many large private insurers, such as Aetna, do cover it. For instance, California’s Medicaid program and insurers like Blue Shield of California cover treatments from a licensed acupuncturist who isn’t a doctor.

How long is an acupuncture session?

Each session may last 30 minutes to an hour, with the needles being retained for 15 minutes or so. Depending on the condition being treated, duration of sessions may be from two to six sessions. Sometimes the patient may have to return for maintenance therapies down the road to ensure long-term benefit.

Which insurance companies follow the 8-minute rule?

All federally funded plans—including Medicare, Medicaid, TriCare, and CHAMPUS—require use of the 8-Minute Rule, as do some commercial payers.

Does Medicare cover acupuncture by a licensed acupuncturist?

covers up to 12 acupuncture visits in 90 days for chronic low back pain. Medicare covers an additional 8 sessions if you show improvement. If your doctor decides your chronic low back pain isn’t improving or is getting worse, then Medicare won’t cover your treatments.

What is the Medicare approved rate for acupuncture?

At present, Medicare funds up to 12 sessions of acupuncture treatment for those with chronic lower back pain. The insured individual will need to pay 20% of the fee that Medicare approves for cover, as Part B accounts for acupuncture, and coinsurance applies.

What does acupuncture treat best?

National Institutes of Health (NIH) studies have shown that acupuncture is an effective treatment alone or in combination with conventional therapies to treat the following:

• Menstrual cramps.
• Tennis elbow.
• Fibromyalgia.
• Myofascial pain.
• Osteoarthritis.
• Low back pain.
• Carpal tunnel syndrome.
• Asthma.

What not to do after acupuncture?

Here’s what to avoid after acupuncture.

• Strenuous Exercise. You don’t have to avoid exercise altogether, but it would probably be best to slow down a bit.
• Caffeine.
• Alcohol.
• Junk Food.
• Ice.
• TV and Other Screens.

What is the rule of 8?

A concept of chemical bonding theory based on the assumption that in the formation of compounds, atoms exhibit a tendency for their valence shells either to be empty or to have a full complement of eight electrons (octet); for some elements there are more than the usual eight valence electrons in some of their …

What insurance companies cover acupuncture?

What Types of Health Insurance Cover Acupuncture?

• Aetna.
• Banner Health.
• Blue Cross Blue Shield.
• Cigna.
• Health Net.
• United Healthcare.

  Is acupuncture covered under insurance?