Network Newsletter

Medicare has just announced that acupuncture will be covered for chronic low back pain. See this link for the Medicare announcement with more information coming from us as it becomes available https://www.cms.gov/newsroom/press-releases/cms-finalizes-decision-cover-acupuncture-chronic-low-back-pain-medicare-beneficiaries?utm_campaign=Acupuncture&utm_source=hs_email&utm_medium=email&utm_content=82254548&_hsenc=p2ANqtz–OUgb0Gm1f-j50Oi4ojzK4OjfJS_2xIiUHXkmSVGIGKmt_gJU0-iRFxdxvZXpgsr7slnYxt3YX7yi10PZBHiwD6JvF6A&_hsmi=82254548  

Optum Health will begin covering the VA for states essentially east and north of Texas. If you’re a provider in VA CCN Regions 1, 2, or 3 and you’re transitioning to Optum for the new CCN contract, you can still accept TriWest authorizations during any overlap period and bill for those services. Read more…

California Blue Cross Claims submitted on or after October 1, 2019 will be subject to a ninety (90) day timely filing requirement, and Blue Cross will refuse payment if submitted more than ninety (90) days after the date of service. If Plan is the secondary payor, the ninety (90) day period will not begin Read more…

Horizon BCBSNJ previously announced plans to collaborate with American Specialty Health (ASH) to implement and administer their Chiropractic & Physical Medicine Services Program for acupuncture, chiropractic, occupational therapy, physical therapy and speech therapy, effective January 1, 2020, subject to regulatory approval by the New Jersey Department of Banking and Insurance. Read more…

BS of CA and ASH has increased reimbursement for 2020 plans ASH plans that affiliate with Blue Shield of California including PPO, HMO, and Medicare Advantage HMO plans have increased the daily reimbursement to $55 for 2020 $45 for the initial set and $10 for an additional set. Therapies also Read more…

2020 ICD10-CM Updates 71,932 codes in ICD10-CM 2018 72,184 codes in ICD10-CM 2019 273 New Codes 21 Deleted Codes 30 revisions As occurs every October 1 there are additions and deletions to the ICD10 code set. This year is had very little change related to acupuncture coding and claims. The Read more…

We have received information from sources with direct contact with ASH representatives that stated that the contract between ASH and Blue Shield of California will not go through if there is not a high enough percentage of providers who enroll Note the benefits nor allowed amounts do not change whether Read more…

WASHINGTON – The Trump administration on Monday proposed a plan to cover acupuncture for Medicare patients with chronic low back pain, framing it as a step that could safely treat pain without supplying more patients with opioids. “Defeating our country’s epidemic of opioid addiction requires identifying all possible ways to Read more…

The latest update for 2020 Blue Shield of California ASH Plans, directly from ASH 1. The Blue Shield PPO plans to move to ASH January 1, 2020, are as follows: • Individual and Family Plans (IFP): on-exchange and mirrored. This is for acupuncture benefits only. These plans do not include Read more…

Medicare will begin a national coverage analysis for the use of acupuncture for chronic low back pain In response to the U.S. opioid crisis, HHS is focused on preventing opioid use disorder and providing more evidence-based non-pharmacologic treatment options for chronic pain. The Agency for Healthcare Research and Quality (AHRQ), Read more…