Billing for Acupuncture and Chiropractors
AMBA 2019 National Conference Summary
Billing for Acupuncture and Chiropractors. Written by Stephanie Cremeans of EZClaim
Acupuncture and chiropractic medicine have faced stigma for some time in the medical field, often considered alternative treatments. As the opioid epidemic continues to grow patients are looking for alternatives and the US is starting to recognize the therapeutic value of both chiropractic and acupuncture treatments. Thanks to the internet, patients can educate themselves on alternatives and as more patients want the treatment, they also approach their self-funded employer plans for coverage of such treatment. As a result, we are seeing more and more insurance plans that will cover the cost of these services.
Requirements for providers vary greatly by state for licensure as well as scope of practice but both acupuncturists and chiropractors can generally bill for Evaluation and Management (E&M) services, and both need to have a very clear understanding of patients benefits. Many insurance plans will combine the number of allowed visits for acupuncture and chiropractic services, and some even include physical therapy visits as well. Unfortunately, both specialties also lack in medical billing training, leaving providers to figure it out as they go.
For providers considering accepting insurance, it is important to familiarize yourself with the guidelines for the specific payers and plans that you would like to contract with as well as the diagnosis and procedure codes that are billable. If you are just getting started, consider working with a consultant to ensure that you are properly enrolled with payers and help you understand the specifics of acupuncture and chiropractic billing for your state.
One recommended consulting firm is RCM Insight.
If you want to go about billing on your own, which we do not usually recommend unless you have the experience, then speak to AMBA so that you can learn the basics. They are a very good organization to get you started.
The EZClaim platform offers its customers a low-cost option that has all the functionality needed to get their claims paid.
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