Cigna and ASH have now updated that the date to join their network to maintain being “in-network” which was June 1, 2021, has now been extended to September 1, 2021. (Note this does not apply to California, Oregon, Washington, and Tenessee.)
But most surprising is the new fee schedules. As many of you read here or from our seminars the amounts proposed were very low and limited from $40-50 per visit inclusive. At that rate, it clearly is unattractive to join as it would be hard to sustain your practice for that level of reimbursement when tied to a 30+ minute visit.
The newest fee schedule under ASH and CIGNA now has reimbursement for the initial set of manual acupuncture at $51 and the second set at $38. Electroacupuncture at $58 and $48 respectively. Therapies including hot packs 97010, electrical stimulation 97014, and infra-red heat now at $18.75.
We believe that that rates had to be raised as there were very few providers interested in joining at those rates and particularly if there was payment out of network. However, the daily maximum rate for acupuncture is $89 for treatment. A representative for ASH did indicate they would pay an additional $18.75 for therapies on top of the $89 for acupuncture. With this, the maximum allowed per date with treatment would be $107.75. However, we are not convinced the therapy is paid separately and not part of the daily maximum and we are awaiting clarification.
E&M rates were unchanged from their prior proposed amounts and are from $20-40 but paid in addition to the treatment on an initial examination.
We recommend you research thoroughly before joining and assure the plan with ASH for CIGNA would also have these rates in your region.
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