Using insurance for acupuncture —
what you need to know
Many insurance plans reimburse acupuncture even when your practitioner is out-of-network. A superbill makes that possible. Here's how it works.
What is a superbill?
A superbill is an itemized receipt that contains everything your insurance company needs to process a reimbursement claim: your practitioner's license and NPI number, the diagnosis codes (ICD-10), the procedure codes (CPT), the date of service, and the amount paid.
When your acupuncturist is out-of-network (OON), they don't bill your insurance directly. Instead, you pay at the time of your visit and your practitioner gives you a superbill. You then submit that superbill to your insurance company for reimbursement. Depending on your plan, you may get back 40–80% of the allowed amount after your deductible is met.
💡 Superbills are sometimes called "itemized statements," "receipts for insurance," or "insurance receipts." All terms refer to the same document.
How to submit for reimbursement
Call your insurance
Ask: "Do I have out-of-network acupuncture benefits?" Get your OON deductible amount, OON coinsurance percentage, and annual visit limit. Ask how to submit a claim.
Get your superbill
After your visit, ask your practitioner for a superbill. It should include their NPI, your diagnosis codes, CPT codes, date of service, and amount paid.
Submit the claim
Submit via your insurer's member portal, the mobile app, or by mail. Attach the superbill. Keep a copy for your records.
Track the claim
Claims typically process in 2–6 weeks. If denied, request a detailed explanation and consider filing an appeal — many are overturned.
CPT codes acupuncturists commonly use
Current Procedural Terminology (CPT) codes tell your insurer exactly what service was performed. These four codes cover the vast majority of acupuncture visits.
Acupuncture — 1st 15 min (no electrical stimulation)
The base code for a standard acupuncture session. Covers insertion and the first 15 minutes of needle retention without electrical stimulation.
Acupuncture — each additional 15 min
Added for each additional 15-minute increment of needle retention. A typical 45-minute session uses 97810 + two units of 97811.
Electroacupuncture — 1st 15 min
Used when electrical stimulation is applied to the needles. Common for pain management and musculoskeletal conditions.
Electroacupuncture — each additional 15 min
The add-on code for additional 15-minute increments when electroacupuncture is used.
Your practitioner may also include ICD-10 diagnosis codes (e.g., M54.5 for low back pain, G43.909 for migraines) to establish medical necessity.
Which insurance plans commonly reimburse acupuncture out of network
OON benefits vary significantly by plan. PPO plans are most likely to include them; HMO plans typically do not. Always verify your specific benefits before your first visit.
Aetna
Covers acupuncture for chronic low back pain in many PPO plans. OON benefits vary widely by plan.
Anthem / Blue Cross
Many Anthem PPO plans include OON acupuncture benefits. Check your EOB for "Acupuncture Services."
Cigna
Cigna Open Access Plus plans commonly reimburse OON acupuncture at 50–70% after deductible.
UnitedHealthcare
UHC Choice Plus and Options PPO plans include OON acupuncture in most states.
Humana
Humana PPO plans often include acupuncture as a covered OON benefit; HMO plans typically do not.
Medicare (Part B)
Covers up to 12 in-network acupuncture sessions per year for chronic low back pain since 2020. OON is not covered under traditional Medicare.
How to check your out-of-network benefits
Call the member services number on the back of your insurance card and ask:
- →Do my benefits include out-of-network acupuncture coverage?
- →What is my out-of-network deductible, and how much have I met?
- →What percentage of the allowed amount will I be reimbursed after my deductible?
- →Is there a visit limit per calendar year?
- →Does acupuncture require a referral or prior authorization?
- →What is the process for submitting a superbill claim?
Pro tip: Write down the representative's name and the call reference number. If a claim is later denied, this documentation supports your appeal.
What to ask your acupuncturist
- ✓
Do you provide superbills?
Not all practitioners do. This is the single most important question.
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What CPT codes do you typically use?
Knowing the codes helps you verify coverage before your first visit.
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What diagnosis codes will you include?
Insurers require a diagnosis to establish medical necessity.
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What is your NPI number?
Required on every superbill. Your insurer uses it to identify the provider.
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Do you accept assignment?
This means the practitioner agrees to accept the insurer's allowed amount as full payment — rare for OON providers but worth asking.
