Insurance

INSURANCE ELIGIBILITY AND BENEFITS

In addition to cash, check, or credit card payments at the time of service, I am also a health insurance provider for BLUECROSS BLUESHIELD, CIGNA, UNITED HEALTHCARE and AETNA.

If you have a BLUECROSS BLUESHIELD FEDERAL PLAN, you will have the following Acupuncture coverage (usually after the deductible has been met):

  • Standard option: 24 visits per calendar year and you pay a 15% copay
  • Basic option: 10 visits per calendar year and you pay a $25 copay

If you have a CIGNA SAMBA HEALTH BENEFIT PLAN, you will have the following Acupuncture coverage (usually after the deductible has been met):

  • 26 visits per year with a copay of 10-35% depending on your plan

In order for me to accept your insurance as payment, the following conditions must be met:

1. Please call your insurance company to confirm that you have Acupuncture benefits. The insurance plan must cover acupuncture as a specialist care for the conditions you are being seen for, and any deductible must be met. If you require a referral or preauthorization, you must have made those arrangements in advance.

2. You must bring your insurance card and a photo ID to your first appointment.

3. At the time of the first appointment, you must sign the agreement with my office that you will pay any funds the insurance will not pay. This includes any copay due at time of service.

We will confirm all of this at the time of service, but in order to prevent any unforeseen charges, you should check with your insurance plan in advance to see what it covers. Especially note that it is possible your specialist copay is different from your regular copay.

If I don’t accept your insurance, it’s possible that you can still be reimbursed for your acupuncture treatment. I can provide you with a receipt that is coded in a way your insurance company may accept it for partial or full reimbursement. Please contact your insurance company to learn their policies about out-of-network acupuncture reimbursements.

FEE SCHEDULE
Procedure CPT-Code Fee
Initial Eval – 10 minutes face to face 99201 $50
Initial Eval – 20 minutes face to face 99202 $80
Initial Eval – 30 minutes face to face 99203 $125
Initial Eval – 45 minutes face to face 99204 $150
Follow Up Eval – 5 minutes face to face 99211 $30
Follow Up Eval – 10 minutes face to face 99212 $40
Follow Up Eval – 15 minutes face to face 99213 $60
Follow Up Eval – 25 minutes face to face 99214 $90
Hot/Cold Packs 97010 $25
Therapeutic Exercises 97110 $40
Neuromuscular Re-education 97112 $45
Manual Therapy 97140 $40
Acupuncture w/o E Stim 97810 $55
Acupuncture addition 15 mins w/o E Stim 97811 $40
Acupuncture with E Stim 97813 $75
Acupuncture with E Stim additional 15 mins 97814 $60
Phone: (202) 378-8033
Fax: (703) 997 6577
803 W Broad St, Suite 720
Falls Church, VA 22046