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Affordable Acupuncture in New Mexico
No referral needed, never a co-pay, and enough appointments authorized per health compliant! Call us for help at 806-268-4894, or call the number on the back of the VA Choice Card, or see Scheduling Reference Guide, or Sign up for Veterans Choice. Programs: PC3 / Patient-Centered Care program &
VCP/ Veterans Choice Program enable Vets to receive acupuncture without a referral if they live 40 miles or more from their nearest DVA
clinic / hospital, or face one of several excessive travel burdens. PC3 uses in-network providers. VCP uses in-network & non-network providers. VAP/ Veterans Affairs program is the standard DVA benefit requiring a referral.
New Mexico Health Connections (NMHC)
NMHC covers $1,500 of acupuncture annually [20 visit limit for 2017]. More is covered for rehabilitative purposes. Prior authorization is not required until after the 10th visit. Co-pay is $0 to $65 depending on plan [see Benefit Plan Summaries.]
American Specialty Health (ASH)
Soon to be credentialed by ASH, a managed-care entity enabling 50+ health insurances nationwide to cover Acupuncture. There are 4 ASH Direct Access or Referral programs: ChooseHealthy, National Plan, Seamless Plan, and Providence Network Plan. ASH Provider Directory.
Health Share Ministries (HSM)
Centers for Medicare & Medicaid (CMS)
Medicaid does not cover acupuncture. Medicare Advantage (MA) plans offer benefits that may cover acupuncture- for example, Medicare Part C Medicare Advantage, and full-featured Medicare policies (e.g. retired state employees). In 2016, acupuncturists were granted a Standards of Occupation Code from the Bureau of Labor Statistics. This allows for the inclusion of acupuncture in federal programs such as CMS. There have been no updates to CMS acupuncture benefits yet.
SuperBills are how patients submit claims themselves, and how insurance companies see what was done during office visits, and
determine what to pay for or not. Example SuperBill1, SuperBill2).
Your acupuncturist provides the Superbill, keeping in mind that private
insurances may limit benefits:
- Limit the number of acupuncture visits per year
- Limit the provider to a Western Medical Doctor vs. a Doctor of Oriental Medicine
- Require prior approval
- Require documentation of prior evaluation by a
physician, nurse practitioner, or physician's assistant
- Require a request for "Restorative Therapy" with
acupuncture if there has been failure of other therapies for the
- Require documentation of treatment goals & expected
- Require documentation of results of treatment at set intervals of time
- Here are some benefit guidelines: Cigna, Aetna, United Health, HealthNet, Health Partners, BlueCross/ BlueShield (Anthem, Excellsus, Regence), Insurance Laws in NM