Initial visit: $130 – 180
Follow-up visits: $70- 100 per session
These are the fees billed to insurance. A prompt-pay discount is applied to payments made at the time of service, for patients without insurance coverage. An additional discount is available to seniors without acupuncture benefits through secondary insurance. Cash, checks and all credit cards are accepted.
Cancellation policy – Cancellations must be made 24 hours before scheduled appointment times. A $25 fee will be charged for late cancellations for either cash or insurance patients.
I am a provider with:
– United Healthcare & UMR
– Anthem Blue Cross/Blue Shield HMO & PPO
– Federal Blue Cross/Blue Shield
– Cigna *except Local Plus plans
– Humana Medicare Advantage plans
– VA Community Care
If you have benefits, but I am out-of-network with your particular insurance plan I will provide you with a CMS1500 form or Superbill to submit to your insurance if you have out-of-network coverage so you can be reimbursed.
If you do have benefits, please obtain the following information- each plan is different, so it is very important to get this information:
- Number of treatments per year?
- Are these combined with other kinds of therapy?
(Often acupuncture and chiropractic are bundled together in that number of visits per year.) - Are you subject to paying a co-pay or co-insurance?
- * A co-pay is the flat amount you will pay at each visit.
- * A co-insurance is the percentage you will owe after the insurance company pays the provider (me) AFTER YOUR DEDUCTIBLE HAS BEEN MET.
- What is your deductible and how much of it have you met? Submitting acupuncture claims that are then applied to your deductible can help you out, but you will have to pay for treatment until it is met. If you have a Health Savings Account, you may be reimbursed this way, or the provider (me) may be paid this way.
Can a Licensed Acupuncturist provide treatment? I am a Licensed Acupuncturist.
- Some plans only allow treatment by an MD. This discrimination is not allowed, per the Affordable Care Act, but some self-funded plans still make this distinction.
What conditions will your benefits cover?
- This tends to revolve around pain issues. Sometimes there is no limitation. Sometimes it is what the insurance company determines to be ‘medically necessary’.
I heard Medicare covers acupuncture!
Yes – in January 2020, Medicare determined that acupuncture treatment services for chronic low back pain would be covered. These acupuncture services need to be billed by a Medical Doctor/Doctor of Osteopathy, Nurse Practitioner or Physicians Assistant with a Medicare Provider number, and the provider needs to be in the same office where the acupuncture services are being done. Acupuncturists are not recognized as Medicare-approved service providers and therefore cannot bill Medicare directly. There are a few Medicare Advantage plans that cover acupuncture, and many licensed acupuncturists are in-network providers with these plans, so it is up to you to find out if your Medicare Advantage plan covers acupuncture and how they cover it – can a licensed acupuncturist bill for these services, or must it be billed by an MD, DO, NP, PA? As of now, acupuncturists are not allowed to bill Medicare directly for any services and I do not work under the direct supervision of any medical care provider with a Medicare provider I.D.
This information should be helpful in figuring out what is best for you. If you have questions
Please feel free to contact me at 720-636-8258 for more details.
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