At Restorative Care Acupuncture & Health, we are a cash-based practice and do not bill insurance directly. However, many patients with PPO or out-of-network benefits may qualify for partial reimbursement for acupuncture treatments.

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We are happy to provide a detailed superbill upon request that you can submit to your insurance company for possible reimbursement.

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What Is a Superbill?

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A superbill is an itemized receipt containing the information your insurance company may require to process an out-of-network reimbursement claim.

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Your superbill may include:

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• Date of service

• Acupuncture procedure code (CPT)

• Diagnosis code (ICD-10)

• Provider information

• NPI number

• Amount paid

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You can usually upload or mail the superbill directly to your insurance company.

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Important Insurance Information

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Insurance coverage for acupuncture varies widely depending on:

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• Your specific insurance plan

• Whether you have PPO or out-of-network benefits

• Your deductible status

• Your diagnosis or condition

• Referral or authorization requirements

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Unfortunately, we cannot guarantee reimbursement.

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Questions to Ask Your Insurance Company

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Before beginning treatment, we strongly recommend calling your insurance company and asking the following questions:

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Acupuncture Coverage Questions

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• Do I have out-of-network acupuncture benefits?

• Is acupuncture covered under my plan?

• Are Licensed Acupuncturists who are not M.D.s (Medical Doctors) covered providers?

• Does my plan reimburse for CPT codes 97810 or 97813?

• What percentage of the allowed amount is reimbursed?

• Has my deductible been met?

• Is there a yearly visit limit for acupuncture?

• Do I need preauthorization or a referral?

• Are there diagnosis restrictions for acupuncture coverage?

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Commonly Covered Conditions

 

Insurance companies are more likely to reimburse acupuncture for conditions such as:

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• Low back pain

• Neck pain

• Sciatica

• Knee pain

• Arthritis

• Headaches and migraines

• Musculoskeletal pain

• Chronic pain conditions

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Coverage for wellness, stress management, or preventive care is less common.

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Realistic Reimbursement Expectations

 

Our treatment fee is $105 per visit.

 

Depending on your insurance plan, many patients with qualifying out-of-network benefits may receive partial reimbursement ranging from approximately:

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Typical Reimbursement Range:

 

$20–$65 per visit

 

Some patients may receive more reimbursement if:

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• Their deductible has already been met

• They have strong PPO benefits

• Their employer-sponsored plan includes acupuncture coverage

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Some patients may receive little or no reimbursement depending on their policy.

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Why Patients Choose Cash-Based Care

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Many patients prefer cash-based acupuncture because it allows for:

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• Simple and transparent pricing

• No insurance-driven treatment limitations

• Flexible treatment plans based on your needs

• Greater focus on individualized care

• No surprise billing

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How to Submit Your Superbill

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Most insurance companies allow claims to be submitted:

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• Through an online member portal

• By mobile app

• By mail

• By fax

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We recommend keeping copies of all submitted documents for your records.

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Need Help?

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If you have questions about obtaining a superbill, our office is happy to help guide you through the process as best we can.

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Please note that reimbursement decisions are made solely by your insurance company.