Wiki Acupuncture coding

[LHenckler]

Afternoon!

I have a question for the group here - new provider coming on board to this practice and in addition to Internal Medicine he would like to provide acupuncture services. We are a small concierge practice in Massachusetts. The provider is still in the process of obtaining a license for acupuncture services and he's hoping to treat clients around June.

Is there some resources or people will to share what are best practices on billing patients when they are receiving acupuncture services? Questions I'm thinking first are patients better off paying out of pocket or us billing the insurance plans? Should he keep his general medicine visits separate from the acupuncture service visits? Also should these visits be vetted to see if their insurance policies does cover acupuncture etc? I'm glad a have a few months to do homework on this!

Thank you in advance!

 

[jkyles]

Hi there,
I'm assuming you all have sorted out the state scope of practice issues and your concierge practice accepts insurance:
1. Can you bill insurance for the services at all? That will depend on the individual patient's coverage (and the provider's contract with the payers) so you will need to look at your patient population and do the research on which plan covers it, including what conditions the plan covers. For example, UHC followed Medicare's lead and covers it for chronic low back pain.
2. Who should you bill? That's a conversation you'll have with your patients. Some patients may be willing to pay out of pocket, some may only want it if their insurance covers it.
3. Should the E/M visits and acupuncture sessions be separate? Again, it will depend. If you have a plan that covers acupuncture it may bundle the service into the E/M visit.

Hope this helps.

 

[LHenckler]

Hi there,
I'm assuming you all have sorted out the state scope of practice issues and your concierge practice accepts insurance:
1. Can you bill insurance for the services at all? That will depend on the individual patient's coverage (and the provider's contract with the payers) so you will need to look at your patient population and do the research on which plan covers it, including what conditions the plan covers. For example, UHC followed Medicare's lead and covers it for chronic low back pain.
2. Who should you bill? That's a conversation you'll have with your patients. Some patients may be willing to pay out of pocket, some may only want it if their insurance covers it.
3. Should the E/M visits and acupuncture sessions be separate? Again, it will depend. If you have a plan that covers acupuncture it may bundle the service into the E/M visit.

Hope this helps.

Thank you so much!