An increasing number of insurance companies are starting to cover acupuncture treatments. We here at Wild Blossom Acupuncture & Wellness are not currently in-network with any insurance companies, nor do we bill insurance on your behalf. That being said, there are a few ways we can provide you with care which may be covered by insurance. You will first want to understand the benefits of your personal health insurance plan.
Do you have a Health Savings Account card? If so, this is the easiest route. You can pay for your acupuncture treatment with an HSA Card.
What does your Health Insurance Plan cover: I highly recommend that you call your insurance company directly. The following are a few specific questions to ask:
Does my plan cover acupuncture? The 2 main procedure codes for acupuncture are 97810 and 97811. We also use code 99201 for the new patient appointment when we do the initial intake.
What are my policies in-network and out-of-network benefits?
How many treatments are covered per year?
Does coverage depend on the diagnosis code used?
(This is an important question for some insurance companies. For example many Quartz plans cover 12 acupuncture treatments a year. However, those treatments are only covered for the following diagnosis: chronic neck pain, chronic low back pain, myofascial pain, nausea due to chemotherapy or pregnancy, migraines or tension headaches and knee pain due to osteoarthritis. Outside of these diagnosis codes, acupuncture treatment won’t be covered.)
Do I need to meet my deductible first?
Is there a copay and if so, how much is the copay?
Both Kathryn and Mary work at UW Integrative Health in Madison, Wisconsin. When we work at UW Integrative Health, we are considered in-network with many insurance companies, likely including yours.
As acupuncture becomes increasingly popular, acupuncturists at UW Integrative Health have not been able to keep up with demand, with a long waitlist for new patients. As a large institution, UW Health policy states that a new patient appointment cannot be scheduled farther out than 30 days. Unfortunately, the schedule is typically full 30-60 days in advance. In addition, often a new patient is only allowed to schedule that one initial appointment. Follow up appointments are then not scheduled until after that first appointment, at which point the next availability to schedule is 1-2 months later. Ultimately this means that it can be difficult to schedule appointments at UW Health within the timeframe that you want to be seen.
Pre-authorization Option: If you call UW Integrative Health and are not able to schedule a new patient acupuncture appointment within the time frame that you want to be seen, you can call your insurance company in order to get a pre-authorization to be seen at Wild Blossom Acupuncture & Wellness. This pre-authorization is a way of having Wild Blossom Acupuncture & Wellness considered in-network instead of out-of-network with your insurance. When you come in, you would pay for your appointment upfront. After the treatment, you then submit a superbill to your insurance company in order to be reimbursed, minus a co-pay. A superbill is a more detailed invoice that shows the procedure codes and diagnosis codes needed to be reimbursed by insurance.
There are certainly pros and cons to getting insurance to cover your acupuncture treatment either at Wild Blossom Acupuncture & Wellness or at UW Integrative Health. At UW, there is less hassle with billing but it's not as easy to get in for those first few treatments. At Wild Blossom Acupuncture & Wellness, we are able to get new patients scheduled fairly easily but there is work on your end in order to get reimbursed.
If you want to schedule with either Mary or Kathryn at UW Integrative Health, call 608-262-9355. Mary works at the Science Drive location on the West Side of Madison and Kathryn works at the East Madison Hospital location on Madison’s East Side. If you want to schedule with us at Wild Blossom Acupuncture & Wellness click “schedule here” and create a patient profile.
Working with insurance is complicated. Feel free to reach out to us if you have any other specific questions. We are always here to help!