This section provides policy and billing information for acupuncture service provided by eligible providers.
The Practice of Acupuncture
The practice of acupuncture means a comprehensive system of health care using Oriental medical therapy, including the insertion of acupuncture needles through the skin, and its unique methods of diagnosis and treatment.
The following licensed practitioners may provide acupuncture:
The following enrollment requirements apply for acupuncturists and chiropractors:
Refer to Provider Basics section of the MHCP Provider Manual for more information on the Provider Requirements and the Enrollment Process.
Members eligible for Medical Assistance (MA) and MinnesotaCare may receive acupuncture services.
Acupuncture is covered only when provided by a licensed acupuncturist or by another Minnesota licensed practitioner for whom acupuncture is within the practitioner's scope of practice and who has specific acupuncture training or credentialing.
Acupuncture is covered for the following conditions:
Items that fall within an acupuncturist scope of practice such as, breathing techniques, dietary guidelines and exercise based on Oriental principles are considered part of an acupuncturist’s visit and are not reimbursed separately.
MHCP allows up to 20 units of acupuncture services per calendar year without authorization. Request authorization if additional units are needed.
Prior to the start of acupuncture treatment, a comprehensive history and physical evaluation of the patient is required to document the cause or origin of the condition being treated. The provider must document this comprehensive history in the patient’s record.
MHCP does not cover maintenance treatment where symptoms are not regressing or not showing improvement. Acupuncture treatment is not considered medically necessary if the recipient does not show improvement in symptoms.
Acupuncture is not covered for the following conditions: (This is not an all-inclusive list of conditions for which acupuncture is not covered.)
To request an authorization, use the MHCP MN–ITS Interactive User Guide (PDF) to log in to MN–ITS and submit a MN–ITS Interactive Authorization Request or, submit the Medical Authorization form (DHS-4695) (PDF) to the authorization medical review agent.
Documentation must include the following:
Use MN–ITS 837P Professional. Refer to the MN–ITS User Guide for claim completion instructions.
Providers are required to indicate the most applicable ICD diagnosis codes when billing acupuncture services.
Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-to-one contact with patient
Without electrical stimulation, each additional 15 minute of personal one-to-one contact with patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)
With electrical stimulation, initial 15 minutes of personal one-to-one contact with the patient
With electrical stimulation, each additional 15 minutes of personal one-to-one contact with the patient, with re-insertion of needles(s) (List separately in addition to code for primary procedure)
"Acupuncture practice" means a comprehensive system of health care using Oriental medical theory and its unique methods of diagnosis and treatment. Treatment techniques include the insertion of acupuncture needles through the skin and use of other biophysical methods of acupuncture point stimulation, including the use of heat, Oriental massage techniques, electrical stimulation, herbal supplemental therapies, dietary guidelines, breathing techniques, and exercise based on Oriental medical principles.
Minnesota Statutes 256B.0625, subd. 8f, Covered Services
Minnesota Statutes 147B.01 Definitions, Subd.3
Minnesota Statutes 147B.02 Licensure
Minnesota Rules 9505.0195 Provider Participation
Minnesota Rules 9505.0205 Provider Records