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Wiki Billing for Acupuncture Services rendered in an FQHC

cedwards

Guru
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173
Location
Branford, CT
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Can you bill Medicare Part A under the facility for acupuncture services rendered in an FQHC? If so, can you please provide me with your source?

If not, do you have a different solution?

See below for the question from my biller.

I’m trying to get more information on billing acupuncture codes to Medicare for denial while remaining compliant with Medicare. We have tried to bill the claims to Medicare Part B with a GY modifier. These claims are starting to come back with a rejection message saying that there is an issue with the rendering providers NPI. The acupuncture providers with our facility do not have an MD sign off on their services so I don’t believe I can add the PCP as the supervising physician. I’m wondering if I can bill the claims to Medicare Part A. We bill Part A claims under the facility, so I don’t need a supervising physician. Medicare does cover acupuncture claims as long as we have a diagnosis of chronic low back pain, but I feel like we should be able to bill for denial because the acupuncturists are not an approved provider type and we do not have the appropriate documentation to add an MD.

Thank you!
 
I have that exact same question. I also would like to know how you respond to patients that question the denial due to provider.
 
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