In recent months, we’ve heard some questions about why FSOMA has been focusing on insurance issues when many APs don’t take insurance. FSOMA certainly recognizes that many practitioners do not take insurance and absolutely supports those practices. However, in accordance with our mission and purpose, FSOMA is committed to delivering necessary updates to advance the practice of ALL Florida acupuncturists. Insurance is currently one of the hottest topics with the most confusion among our members, which drives this topic to the forefront of our attention, resulting in increased publicity.
Recently, acupuncturists who accept insurance have been running into significant roadblocks, similar to many other medical providers, who find it challenging to get adequate reimbursement. The most current issue is that some of the major policies have started denying Evaluation and Management (E&M) CPT codes and, in some cases, recouping them back. The main reason for this denial is a lack of awareness from the Acupuncturists about recent changes from time-based E/M to Medical Decision Making (MDM) based documentation and coding according to the 2021 Centers for Medicaid & Medicare Services (CMS) guidelines.