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 Medicare. These payments may have been as much as $100+ per set. But Medicare rates are substantially lower about $40 for initial set and $30 for additional sets. Note there is a variation based on your region as Medicare does adjust fees based on location. Think just like real estate.

Based on these new rates VA is taking back monies from payment or requesting repayments. However, they do recognize hardships and in particular during COVID. If you receive a request or have had monies recouped you may contact Triwest at 866 651-4977. You may request that immediate offset will cause financial hardship during the pandemic. You can also negotiate a one-time payment (negotiated for less than the full amount) and review your account directly with them.

The recoup should be only for the acupuncture codes as the other codes 99201-99215, 97016, 97110, 97112, 97124, 97140, 97530 were always at the Medicare rate.




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