We are often asked which codes should be used for AcuGraph® exams and acupuncture treatments. In an effort to provide you some direction, we have put together this short synopsis, subject to the following disclaimer:
We provide the following information “as-is” with no warranty as to correctness, suitability for any particular billing situation, or guarantee of reimbursement. How you bill is strictly your business and your responsibility. We cannot be held responsible for how you use this information. Use at your own risk, your own discretion, and subject to your own references, professional advice, and insurance contracts.
Now that we’re clear on that, here’s what we hear most users are doing:
- Bill under an exam code as part of an exam or office visit. Most commonly you would use:99201 or 99202 New Patient Exam
99211 or 99212 Established Patient Exam (you may need to add modifier –25 to signify that this is a significant, separately identifiable service)Please make sure that your office visit meets the correct requirements for the above codes, including time spent, complexity of decision making, history, examination, severity of situation, etc. Consult your insurance reference book or billing professional for more information.
- Bill the AcuGraph® exam directly to the patient as a non-covered service, and bill insurance for the treatment, if it meets the correct guidelines. Common treatment billing codes include:97014 Unattended Electric Stim.
97032 Attended Electric Stim.
97810 Acupuncture (requires insertion of one or more needles)
97813 Acupuncture with electric stim (requires insertion of one or more needles and electric stim)Again, your particular provider may not reimburse the above codes. We urge you to check with your insurance provider and/or your billing professional.
There are a few schools of thought on charging fees for an AcuGraph exam.
- Cash Fees that are charged every time you perform an exam: AcuGraph® exam fees like this range from $25-$75, with $30-50 being the most common. Charges for treatment are in addition to these fees. Most users report patients are generally very willing to pay for the examination and resulting report. Keeping the fee affordable allows you to perform the exam more often, which helps your patients and helps you. In our limited tracking of this, lower fees have generated the most interest and the most income.
- A modest price increase for your general service fee: This is the most common approach that we have seen from the most successful practitioners. Kimberly wrote a blog post about how she does this method in her practice and what the modest change means to her bottom line. Also note: A.) using this method allows you to pick and choose whatever each patient needs, without instilling fear that they’re racking up a huge bill with every little thing you do; and B.) this is the best method for constant graphing, monitoring, and ongoing patient communication, as well as building patient confidence and expectations for each visit.
If you want to have a copy of the above CPT codes to print and keep as a reminder for easy access, feel free to download the PDF document here.
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