Billing and Coding: 2021 VA Rate Changes

Welcome to your billing and coding weekly solutions by American Acupuncture Council Network (AAC).

Are you aware of VA rate changes for 2021?

As of January 1, 2021, the US Department of Veterans Affairs (VA) phased in a new approach for its community care fee schedule payment rate calculations that better align VA to industry best practices.

Instead of rates being calculated based on the location of the referring VA medical center, rates are now calculated based on the location of where the care is provided. Thus payment rates under the VA fee schedule may be different from 2020.

VA generally reimburses at the applicable Medicare rate published by the Centers for Medicare and Medicaid Services (CMS). However, when no CMS rate is available, VA and Third Party Administrators reimburse at the lesser amount of (1) billed charges or (2) the VA fee schedule rate (amount published for the designated date of the service time period).

Remember, billing with incorrect acupuncture CPT and ICD codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then American Acupuncture Council Network is your solution.

American Acupuncture Council Network stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.

There is a reason acupuncturists have trusted AAC with their business for over 30 years.