Is there a limit to the amount of sets an Acupuncturist can bill for?

The Current Procedural Terminology (CPT) codebook states there is no limit to the Acupuncture sets utilized; however, you must…

Welcome to your billing and coding weekly solutions by American Acupuncture Council Network (AAC).

What is an Acupuncture Set?

An Acupuncture Set is a billing term for a 15-minute session of Acupuncture treatment.

Most Acupuncturist treat from 30-45 minutes, which equates to 2-3 billing sets.

Is there a limit to the amount of sets an Acupuncturist can bill for?

The Current Procedural Terminology (CPT) codebook states there is no limit to the Acupuncture sets utilized; however, you must spend 15-minutes face to face with the patient, with the insertion of needle(s) to qualify for 1 single set.

Of course, the number of Acupuncture sets should always depend on the necessity to properly address your patient’s condition(s) being cared for.

To assure proper documentation your notes must include:
1. The face-to-face time for each set (this includes but is not limited to greeting the patient, day-to-day evaluation, insertion, and removal).
2. The points of insertion for each set.

Remember, billing with incorrect acupuncture CPT and ICD codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then American Acupuncture Council Network is your solution.

American Acupuncture Council Network stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication

There is a reason acupuncturists have trusted AAC with their business for over 30 years.


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