Does BCBS Cover Acupuncture? What Patients in Asheville Need to Know

by Nicole Johnson, MFA, CHHC | Insurance & Access

Yes. Many BCBS PPO Plans Do

Many Blue Cross Blue Shield plans do, particularly PPO plans for pain-related conditions. Coverage depends on your specific plan type, your state, and your diagnosis. This post explains what to check, how we handle insurance at our Asheville Acupuncture clinic, and what to expect when you come in

Our work is patient-centered, results-driven, and root-cause oriented. You do not need to confirm coverage before coming in.

Do You Need to Confirm Coverage Before Your First Visit?

Not necessarily, and here is why.
Many of our patients come in, experience real results in their first treatment, and decide to pursue BCBS reimbursement afterward. Others come in knowing their plan will not cover it and decide the care is worth it. A smaller group genuinely needs to confirm coverage before committing, and that is completely valid too.

You do not need pre-authorization to be seen at our clinic. You can call us, book online, and come in.

Chad Johnson LAc performing palpation during an orthopedic Acupuncture treatment at Moxa House in Asheville NC

Does BCBS PPO Cover Acupuncture?

Chad Johnson LAc performing Acupuncture intake at Asheville Orthopedic Acupuncture at Moxa House in Asheville,NC

Yes, many BCBS PPO plans cover Acupuncture. Coverage expanded significantly after a 2020 decision to include Acupuncture for chronic low back pain, and many private insurers including Blue Cross Blue Shield followed. BCBS PPO plans generally offer the most flexibility for Acupuncture coverage compared to HMO plans.

Conditions most commonly covered under BCBS PPO plans include chronic low back pain, neck pain, osteoarthritis, headaches, and post-surgical pain management.

What About Anthem BCBS, Empire BCBS, Horizon BCBS, and FEP Plans?

Because Blue Cross Blue Shield operates through regional plans, each one has its own benefit structure. Anthem BCBS, Empire BCBS, Horizon BCBS, and Federal Employee Program (FEP) plans all handle Acupuncture coverage differently.

CALL MEMBER SERVICES AND ASK:

Does my plan cover Acupuncture?
How many visits per year are covered?
Is prior authorization required?
Do I need to see an in-network provider?

Does Medicare Cover Acupuncture?

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Medicare Coverage

Medicare technically includes Acupuncture as a covered benefit for chronic low back pain. In practice, coverage requires direct physician supervision, a structure that is not how Acupuncture is practiced in most real-world clinical settings.

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Out-of-Network Status

Acupuncturists in North Carolina cannot currently accept Medicare assignment directly. This is actively being worked on at the state and national level, but has not changed yet.

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Supplemental Insurance Coverage

Many Medicare patients carry supplemental plans that cover acupuncture independently. Call your supplemental provider and ask if acupuncture is a covered benefit and how many visits are included per year.

We will always be straightforward with you about what your insurance is likely and unlikely to cover.

How Do I Get Reimbursed for Acupuncture with BCBS?

We are an out-of-network provider. We do not bill insurance directly, but we provide a superbill after every visit. A superbill is an itemized receipt that includes the diagnostic and procedure codes your insurance company needs to process a reimbursement claim. Many patients with BCBS PPO out-of-network benefits receive meaningful reimbursement depending on their deductible and plan terms.

If your plan requires in-network providers only, we are happy to help you understand what to look for when searching for an in-network Acupuncturist.

What Does Treatment at Our Asheville Acupuncture Clinic Look Like?

We are a results-driven, root-cause oriented clinic. Our goal is to get you better in as few treatments as possible. We start with a base framework:

ACUTE CONDITIONS:

Begin with three treatments, once per week for three weeks.

CHRONIC OR COMPLEX:

Begin with five treatments and adjust based on how your body responds

PACKAGES AVAILABLE:

We offer packages for small groups of follow-up treatments for patients who want to plan ahead.

Our reputation is built on results, not return visits.

We’ve been practicing in Asheville for over 14 years. We live and work in this community. When you call, you’re speaking with an owner. We’ll always be straight with you about what your insurance will and won’t cover.

Have questions about coverage or cost?

Give us a Call

BCBS of TN Covers Acupuncture for Pain

by Nicole Johnson, MFA, CHHC | Insurance & Access

As an alternative to opioids, BCBS will now cover acupuncture in TN. North Carolina is not far behind.

Knoxville Acupuncture

Effective January 1, 2019, BlueCross of Tennessee removed Oxycontin and added acupuncture to help with the opioid crisis.

Access the story by clicking here.

Asheville Acupuncture

North Carolina Society of Acupuncture and Asian Medicine (NCSAAM) has been working with the Blue Cross Blue Shield Med Director and Chief Policy Analyst. Due to their ongoing efforts, there is good probability that BCBS of North Carolina will include acupuncture as a benefit in the next 2 years.

Pain is the most throughly researched indication for acupuncture.

Our friends at Evidence Based Acupuncture have compiled the latest state of medical research on the subject. Read Acupuncture Medical Research on Efficacy for Pain.

Are you in Pain?

You don’t have to suffer. We can help.

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