Non-covered diagnoses
Claims denied for diagnoses outside coverage. Benefits verified before treatment.
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Acupuncture medical billing services
Acupuncture billing is limited by coverage: Medicare pays only for chronic low back pain under specific conditions, and commercial coverage varies plan by plan. Practices that collect well verify benefits before the first needle and bill time-based codes precisely.
What makes acupuncture billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether acupuncture claims pay the first time.
- Acupuncture codes (97810, 97811, 97813, 97814) are 15-minute time-based codes for initial and additional sets, with and without electrical stimulation.
- Medicare covers acupuncture only for chronic low back pain, with visit limits and supervision requirements for non-physician practitioners.
- Commercial plans vary in visit limits, covered diagnoses and whether a referral is required.
- E/M on the same day requires a separately identifiable service and modifier 25.
Denials we see most in acupuncture
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Visit limit exhaustion
Sessions denied beyond the plan limit. Tracked per patient.
Time documentation
Time-based codes denied for missing minutes. Documentation template provided.
How Core MB bills for acupuncture
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new acupuncture providers runs in the same system, tracked live in your client portal.
- Benefit verification by plan and diagnosis before treatment starts.
- Visit-limit tracking per patient and payer.
- Time documentation support for 15-minute codes.
Everything in the service
The full revenue cycle as standard for acupuncture practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Acupuncture billing questions
Does Medicare cover acupuncture?
Only for chronic low back pain, with limits on visits and specific requirements for who provides it. We verify eligibility under those rules.
How do I know if a patient's plan covers acupuncture?
We verify benefits before the first visit, including covered diagnoses, visit limits and referral requirements, so you know before treating.
Can we bill an exam with acupuncture?
Yes, when a separately identifiable evaluation is documented, with modifier 25.
How do we get started with Core MB for acupuncture billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new acupuncture providers can start at the same time.
More in therapy, rehabilitation and musculoskeletal
Find out what your acupuncture billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.