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VA increasing payments September 1, 2020
The VA will increase payments for acupuncture providers for services on or after September 1, 2020. Acupuncture providers will no longer be classified as mid-level providers. Mid-level providers are physician assistants and nurse practitioners who under Medicare are paid at 85% of the Medicare rate. Acupuncture providers were also labeled
Requesting a hardship waiver for VA recoupments of acupuncture payments
Many acupuncture providers may be receiving recoupment of payments from VA claims. VA fees are always based on Medicare rates and before January 21 of this year there was no Medicare fee for acupuncture and acupuncture providers were paid at their local usual and customary which is substantially higher than
MUE and reduction of units of acupuncture.
The medically unlikely edits (MUE) do limit 3 units of acupuncture 1 initial set and up to 2 subsequent sets. However, Empire BCBS (New York) is taking a step further and denying any additional sets. It is worth an appeal to note specifically the edits indicate 3, not 1 set
Medically Unlikely Edits limiting acupuncture to 3 sets per visit on some plans
United Health Care and CIGNA have begun using Medically Unlikely Edits (MUE) to limit acupuncture to 3 sets per visit regardless of manual or electrical. n this policy, CMS Medically Unlikely Edits (MUE) it indicates âIn accordance with the code descriptions and/or the Centers for Medicare and Medicaid Services (CMS)
COVID-19 Forms and Protocols
AcuCode subscribers there are now multiple COVID related forms available in the document library. This includes a comprehensive informed consent for patients to sign as well as a detailed office safety procedures and protocols. Stay informed and assure you are following the best practice protocols for your office. Network members
AcuCode updates to Insurance Coverage Policies
There have been updates in the AcuCode Document Library. Updated coverage guidelines for Aetna, CIGNA, Evicore, and Health Partners for 2020. Note these documents provide the specific diagnoses codes that are reimbursed for acupuncture related services. You should review your common code lists and verify whether the code you are
Telemedicine Update for California Workersâ Compensation
Telemedicine Update for California Workersâ Compensation California workersâ compensation will pay for telemedicine visits. Providers should bill with an office visit code 99211 to 99215 with modifier 95. However, the place of service for California workersâ compensation claims would remain 11. Also, they have added the following codes for reimbursement
CIGNA Policy for Virtual Care Telemedicine
CIGNA Virtual Care Guidelines In an effort to remove barriers for our customers to access timely and safe care, while ensuring that providers can continue to deliver necessary services in necessary settings, Cigna will allow providers to bill a standard face-to-face visit for all virtual care services, including those not
Anthem Policy for Telemedicine
There is confusion relating to the ability to use and be reimbursed for telemedicine as some have interpreted improperly the payment policy for Anthem related to chiropractic and other licensed providers. For telephonic only there is exclusion of payment to these provider types but not for âtelemedicine -video+audioâ This information
On-Line Digital Evaluation & Management Services: Updated information on Telemedicine
Providers who have patients that cannot make appointments due to need for isolation, quarantine, or social distancing may still need your management and when done as an online evaluation or phone call there are three code sets that may fit this scenario. Special Note: Non-secure platforms may be used
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