What is acupuncture?
Acupuncture is a form of traditional Chinese medicine that involves inserting very thin, sterile needles into specific points on the body. It helps stimulate the body’s natural healing ability, improve circulation, and restore balance.
Does acupuncture hurt?
Most people feel little to no pain. The needles used in acupuncture are extremely thin, much thinner than regular medical needles. Many patients feel relaxed during treatment and some even fall asleep. 😊
What conditions can acupuncture help with?
World Health Organization (WHO) has recognized that Acupuncture is a valuable and readily method through over 2500 years of historical practice. During clinical practice, Acupuncture can significantly improve many conditions, such as Common Cold, Allergies, Body Injuries and Pain, Digestive Disorders, Headaches and Migraines, Diabetes, Stroke, Insomnia, Fatigue, Female Period Disorders, Infertility, and many other issues. Please visit the official WHO website or the National Institutes of Health (NIH) official website to find out more information.
How many treatments will I need?
It depends on the condition and how long you have had it.
Some patients feel improvement after 1–3 treatments, while chronic conditions may require a series of treatments over several weeks.
Is acupuncture safe?
Yes. When performed by a licensed acupuncturist, acupuncture is very safe. We use single-use, sterile needles and follow strict safety guidelines.
What should I do before my acupuncture appointment?
Please:
Eat a light meal before your appointment
Wear loose and comfortable clothing
Bring your medical history if needed
Arrive relaxed and hydrated
What should I expect during the first visit?
Your first visit usually includes:
Health consultation
Diagnosis according to Traditional Chinese Medicine
Personalized treatment plan
Acupuncture treatment
The first visit usually takes 45–60 minutes.
Are the needles disposable?
Yes. We only use single-use, sterile, disposable needles to ensure safety and hygiene.
What should I do after treatment?
After acupuncture:
Drink water
Avoid intense exercise for a few hours
Relax and allow your body to respond to the treatment
Some patients feel very relaxed or energized afterward.
Common Insurance Questions
Navigating insurance can be complicated. Hopefully, this information will help you get an accurate answer from your insurance provider.
There are a couple of cases where the answer is almost always YES:
- Were you recently in an automobile accident and haven’t used all of your Personal Injury Protection (PIP) coverage? Kentucky requires a minimum of $10,000 in PIP for all auto insurance and this can be used for acupuncture, massage, and chiropractic in addition to other regular medical expenses. If so, we can bill your insurance or you pay cash and submit the receipts for reimbursement in most cases.
- Are you a federal employee who was injured on the job? If so, federal workman’s compensation coverage may include acupuncture. Contact us for more information.
- Are you an employee with an open workman’s compensation claim? If so, you may be able to get acupuncture coverage with a referral from your primary workman’s compensation doctor.
There are also cases where the answer just might be YES:
- Are you a federal or state employee? If yes, your plan may include acupuncture coverage.
- Are you a veteran under the care of the VA for a service-connected disability? We just might be able to get you a referral through the VA which will cover 100% of your approved treatments for acupuncture and massage.
- Are you an employee of a health insurance company? Many of these companies have plans that cover acupuncture for their employees even if they don’t provide it to their customers.
There are several cases where the answer will generally be NO:
- Tricare, Medicare, and Medicaid do not cover acupuncture and due to the abysmally low reimbursement rates, we do not accept any Medicare supplement plans currently.
*Note regarding recent Medicare changes*
While Medicare does cover Acupuncture for chronic low back pain only, we are limited to being an out of network provider until Congress amends the law to include licensed Acupuncturists as providers. We are happy to guide you to the necessary paperwork for you to submit for reimbursement but have no control over Medicare’s ultimate decision. In addition, we cannot accept Medicare supplement insurance plans due to the restrictive nature of their reimbursement criteria.
Do you have a Health Saving Account, Flex Spending Account or similar?
Yes. We take HAS or FSA card.
How do I know if my insurance covers acupuncture?
You can:
Call the number on the back of your insurance card
Ask our office to help verify your benefits
We will check your coverage and explain your benefits before your appointment.
Do I need a referral from my doctor?
Some insurance plans require a referral from your primary care physician, while others do not. We recommend checking with your insurance provider.
What will my out-of-pocket cost be?
Your cost depends on your insurance plan and may include:
Copay
Coinsurance
Deductible
We will do our best to estimate your cost after verifying your insurance benefits.
How many acupuncture visits does insurance cover?
Coverage varies by plan. Some plans allow a certain number of visits per year, while others cover visits based on medical necessity.
What if my insurance does not cover acupuncture?
If your insurance does not cover acupuncture, we offer affordable self-pay options. Please contact our office for pricing.
What information do you need to check my insurance?
Please provide:
A copy of your insurance card
Your date of birth
The policy holder’s information (if different)
Will you bill my insurance directly?
Yes. If we are in-network with your insurance plan, we will submit the claim to your insurance company on your behalf.
Is insurance verification a guarantee of coverage?
No. Insurance verification is only an estimate. Final payment is determined by your insurance company after the claim is processed. Our team is happy to assist you in understanding your insurance benefits before your appointment. When possible, we will notify you of any outstanding balance before charging the card on file. Statements or receipts are available upon request.
Questions about your benefits? Coverage varies by plan. We’re happy to help you understand your benefits, but we recommend contacting your insurer for specific coverage details.
Because we are focused on overall health and wellness, it is important to us that you understand the terms “Medically Necessary” and “Clinically Appropriate.”
“Medically Necessary” is defined by your insurance carrier as treatment or service that is specific to your diagnosis and which your insurance company will pay for per your contract with them. The insurer only pays for care that has a direct connection to documented improved function. There may be specific limits to your coverage or specific services that are not covered, and this also is determined by your carrier.
“Clinically Appropriate”: For example, if you have a neck or lower back condition, your treatment plan may have to be extended beyond the insurance company’s standardized limitations to provide you full pain relief. At some point later in your treatment, we may not be able to document significant improvements in range of motion or other objective functional capacity measurements the insurers often require. Insurance companies often deny care at that point even though the treatment continues to manage, reduce, or eliminate your pain. This is “clinically appropriate” for your circumstances but may not be considered “medically necessary” by your insurance carrier.
Your insurance company makes the final determination on whether a service is medically necessary and will be covered.
It is our policy to keep a valid credit or debit card on file to ensure prompt payment for any charges not covered by insurance.
My insurance says they cover acupuncture, now what?
To help make sure you get the coverage you pay for, there are some additional questions you need to ask your insurance company:
- Do you cover acupuncture? ______________ If yes: Are there any specific diagnosis codes required for coverage or excluded from coverage? __________________________________It is important to get the ICD code, not just condition name!
- Do you cover CPT codes 97810, 97811, 97813, 97814? These are acupuncture specific codes—some insurance will say they cover acupuncture but in fact, they only cover the office visits and not the acupuncture itself.
- How many visits do you cover? ___________________
- Does my deductible have to be met prior to my coverage being effective? ______________
- How much is my deductible and how far away am I from meeting it this year? ____________
- Do you require an MD referral? _________________________________
- Some will say they only cover in-network providers or that they cover a higher percentage for in-network providers. Currently there are no insurance contracts with acupuncturists in the state of Kentucky, so they are required to give you an exemption if you request it and treat us as if we were in network. It is not uncommon for them to “not be aware” of this but if you mention that you will “contact the state insurance board about their inability to provide an exemption” and they generally remember.