Insurance Committee Report

This past year has been challenging, but we have still managed to get a few things done.

In January 2020 CMS announced the decision to include acupuncture benefits to Medicare patients for chronic low back pain. They will cover 12 visits in a 90-day period with an additional 8 treatments total for the year. The details of this can be found at www.cms.gov/index.php/newsroom/press-releases/cms-finalizes-decision-cover-acupuncture-chronic-low-back-pain-medicare-beneficiaries. http://www.cms.gov/index.php/newsroom/press-releases/cms-finalizes-decision-cover-acupuncture-chronic-low-back-pain-medicare-beneficiaries  The ASA is continuing to work with insurance companies to ensure that our reimbursement rates are not affected. They are also continuing to work on expanding this Medicare inclusion with the ability to opt out should any DOM choose to do so.

 We offered a Mori West seminar at a discounted rate. Members were able to take any of her webinars and receive a 20% discount.

With the Covid-19 pandemic we all had to make adjustments to how we can treat our patients. We confirmed that Presbyterian will reimburse DOMs for evaluation and management done via telemedicine as long as a modifier of 95 is used. Other insurance companies reimbursing for telemedicine include Blue Cross and Blue Shield and True Health New Mexico. This has been extended to January 2021.

Our legislative committee is already working on bills for the 2021 session that will benefit those DOMs who bill insurance. Most likely we will again submit an Oriental Medicine Cost Sharing Limits bill, which would lower our patients’ copays. A similar bill passed last session for PTs, so we have a better chance of getting it passed.  

Insurance companies have updated their reimbursement rates which go into effect October 1. Check with your individual contracted companies to get the latest fee schedules.

Amanda Wheat, DOM
Insurance Committee Chair