Acupuncture is a treatment method that has been used for thousands of years, and has been found to be beneficial in many conditions. Both the World Health Organization and the National Institutes of Health have recognized the benefits of acupuncture as a medical treatment. However, there are many medical insurance companies that do not pay for acupuncture treatment.
Your initial visit, whether or not it includes acupuncture, will be paid for by most insurance companies because an evaluation for medical acupuncture includes a history and physical examination and its primary purpose is medical evaluation for your particular problem.
If your insurance company does not pay for acupuncture, the self-pay fee is $90.00 for an acupuncture treatment payable by check or cash at the time of your visit. Because re-evaluation and management is an integral part of your treatment, your insurance company may be billed an evaluation and management fee.
Medicare and most of the Pennsylvania Blue Cross plans do not pay for acupuncture. Some insurance companies pay for acupuncture for certain diagnoses. To understand your covered benefits for acupuncture treatments, we recommend you call your company directly. Indicate that acupuncture charges are coded as 97810 or 97813. Let them know for what condition (for example Back or Neck Pain, Headache etc.) you are going to be treated.
Our office will work with you to help you understand your insurance coverage and your particular plan’s acupuncture policy. Please feel free to call us before you make an appointment with any questions regarding insurance coverage and payment issues.