Acupuncture Benefits and Coverage

Question: How do I know if I have acupuncture benefits that can be used at Pin IT Up Acupuncture?

Answer: We recommend you follow the below steps to learn about your coverage with CareFirst-BlueCross/BlueShield, Aetna, and/or UnitedHealthcare/OPTUM.

  1. Call the Customer Service phone number on the back of your Health Insurance Member ID card.

    1. If you need it, Click here for a list of Common Health Insurance Terms.

  2. Ask for a representative, so that you can speak to a person and not a machine. Please be patient this can take some time and effort.

  3. Inform the representative that you want to know what your Acupuncture coverage and benefits include?

    1. Inform the representative that this is for “In Office” acupuncture treatments, with an “In Network” “Licensed Acupuncturist.”

  4. Questions to ask:

    1. Do I have any Limitations?

    2. How many Acupuncture Treatments can I have a year?

    3. Do I need to meet a my deductible?

    4. What is my copay, if any?

    5. Do I have a coinsurance cost?

    6. Are there any other out of pocket costs?

  5. If you want to know about any additional charges for the Procedure Codes most commonly used at Pin IT Up Acupuncture, then ask your Health Insurance representative “Are there any cost to me for any of the following Procedure Codes”? (These are the most common procedure codes used at Pin IT Up Acupuncture, but not limited to.)

    ·      99205  with Modifier 25

    ·        99211  with Modifier 25

    ·        99212  with Modifier 25

    ·        99213  with Modifier 25

    ·        99214  with Modifier 25

    ·        99215  with Modifier 25

    ·        97810

    ·        97811

    ·        97039

    ·        97016

    ·        97026

  6. Be sure to write down all the information you are given.

  7. At the end of your call ask for a Reference Number. Write down the Reference Number and the Date and Time of the phone call.

    1. The Health Insurance calls are Logged and often Recorded, this Reference Number will help you refer back to all the information you were given during this call. It is a good thing to have, in the event that your Health Insurance charges an amount different then what you were told during this call.

Pin IT Up Acupuncture can not guarantee any of your Health Insurance Coverage for Service, since we are your wellness provider and not the Health Insurance company. However, we hope these guidelines assist you in understanding your policies as best as possible. In the event you have a question about your Insurance Billing from within our offices, please contact us directly and we will provide the contact information to our Billing Department.