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Outpatient Acupuncture Services Restored for FQHC/RHC Providers

March 15, 2018

In addition to the restored billing policy for outpatient acupuncture services described in the February 2018 Medi-Cal Update, Federally Qualified Health Center and Rural Health Clinic (FQHC/RHC) providers should also be aware of the following:

  • Acupuncture services, among other specified optional services, are limited to two services in any one calendar month, or any combination of two services per month per recipient, when rendered in an RHC or FQHC, except as otherwise authorized for medical necessity.
  • A face-to-face encounter with a licensed acupuncturist is considered a reimbursable visit under FQHC/RHC billing policy.

Updated manual pages reflecting these changes will be released in a future Medi-Cal Update.

Additionally, beginning January 24, 2018, providers have received a 90-day timeliness override for billing acupuncture services for dates of service on or after July 1, 2016. No action is required by providers. As expressed in the February 2018 Medi-Cal Update, an Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims.