Specialty billing
Acupuncture billing services
Acupuncture billing is coding each treatment by its minutes of one-on-one needling and whether electrical stimulation was used, then claiming it under the patient’s plan’s acupuncture coverage.
Acupuncture
Medicare’s acupuncture year
- Visits 1–12within 90 days
- 8 moreif the patient is improving
- 20the most in a year
Try it
Count a session’s acupuncture codes
Four codes, counted in 15-minute increments of one-on-one contact, with or without electrical stimulation.
Which acupuncture codes?
15-minute incrementsOne-on-one contact in one day’s session.
15-minute increments
Electrical stimulation
- 97810
- 97811
One initial code a day (97810), and an add-on for each further 15 minutes that included re-inserting needles.
Why is acupuncture billing hard?
Four codes, counted in 15 minutes
Acupuncture is billed in 15-minute increments of personal, one-on-one contact: 97810 and 97811 without electrical stimulation, 97813 and 97814 with it. One initial code is billed a day, with an add-on for each further increment that included re-inserting needles.
Medicare covers one condition
Medicare covers acupuncture only for chronic low back pain: up to 12 visits in 90 days, 8 more if the patient is improving, and no more than 20 a year.
Acupuncturists can’t bill Medicare alone
A licensed acupuncturist can’t enroll with Medicare. Covered acupuncture is billed by a physician or other eligible practitioner, and an acupuncturist’s treatment is covered only under their supervision.
Every plan covers it differently
Commercial plans may cover acupuncture for some conditions, cap the visits or leave it out, and auto and workers’ compensation claims follow their own rules.
What Beeline handles for acupuncture practices
- Eligibility verificationAcupuncture benefits checked before the first visit: whether it is covered for the patient’s condition, how many visits are left and what the patient owes.
- Medical codingEach treatment coded from the documented minutes and stimulation, one initial code a day with the add-ons the time supports.
- Claims submissionClaims sent with the diagnosis the plan’s acupuncture coverage requires, and Medicare claims under the supervising practitioner.
- Denial managementDenials for coverage, visit limits or units traced to their cause, then corrected or appealed.
- Credentialing & enrollmentPractitioners enrolled with the plans that cover acupuncture, and kept current.
Acupuncture billing questions
What CPT codes are used for acupuncture?
Does Medicare cover acupuncture?
Can a licensed acupuncturist bill Medicare directly?
Find out where your acupuncture billing stands.
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