As of November 1, 2018, Alex Leddy Acupuncture will no longer be accepting Anthem Blue Cross Blue Shield insurance. We are happy to provide Superbills for patient records or for patients to submit themselves. Thank you and we apologize for any inconvenience.
Most acupuncturists develop their fees by figuring out how much they want to charge for a visit and including everything they do in that fee. For example, an acupuncturist may charge $60 (this number is not based on anything nor is it a suggestion of any kind) for a visit and provide acupuncture, heat packs on the back, a heat lamp on the feet, and massage with liniment for a few minutes after the acupuncture. This will not work for insurance billing.
Insurance billing requires a separate code (Current Procedural Terminology codes, or CPT codes) for each procedure or service performed. Each of the services described in the previous paragraph has a separate code. And each is individually reimbursable. This has pros and cons. It may mean that you can get more money than the $60 by listing each service separately. Of course, insurance may not pay an acupuncturist for each of these services. Or insurance companies may deny some of them but not all of them, meaning more paperwork hassles. But many will pay for each and every one. In California’s workers compensation system, the reimbursement for the treatment described in the previous paragraph would be around $132. Anyway you look at it, improper coding, including packaged services, is unethical, possibly illegal, and can have ramifications.
A proper fee schedule will have individual codes and how much is charged for each of these codes. Charting should include individual services and their corresponding charges. What the charges are for each code is completely up to the individual practitioner. These charges can be influenced by competition, geographic location, and other business factors.
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Monday: 8 am-6 pm
Tuesday: 8 am-6 pm
Wednesday: 8 am-6 pm
Thursday: 8 am-6 pm
Friday: 8 am-6 pm
Saturday & Sunday: Closed