Insurance & Cash Rates
Seattle, Tacoma & Bellevue Clinics
Make sure to call your insurance to verify your acupuncture benefits:
Acupuncture Northwest does NOT call to check a patient's insurance benefits.
Use this insurance benefits questionnaire to call your insurance.
The basic questions are:
- Do I have acupuncture benefits?
- Can I get acupuncture for _________________ (whatever you are coming in for)? Some plans only cover acupuncture in lieu of anesthesia during surgery!
- If you are coming in for fertility acupuncture, the most common diagnosis code (ICD-10) for female infertility is N97.9. Ask them if they cover acupuncture (CPT Code 97810 and 97811) for fertility and give them these codes.
- If they say yes, get their name and right down the day that you talked to them (they record these calls) so that you can refer back if they end up denying your claims.
- If we are not in your network, you may have out of network acupuncture benefits.
- You can use your HSA card for your acupuncture if we are out of network with your health insurance plan.
- Know that if you bill your insurance and your insurance ends up denying your claims, the cost will end up being much higher than if you paid on the day of your visit and got "the time of service" discount, which we can only give at the time of service. This is why you should call your insurance company before you start treatment.
- We are happy to bill your insurance but it is up to you to know your benefits and to keep track of how many visits you've had so that you know when you have run out of benefits for your "benefit year" (which might not be the calendar year!).
- We will not be able to offer the time of service discount after insurance has been billed, in the event that your insurance denies the claims.
- Phew, that was a lot! We hope this helps clarify some billing questions. Please do use the questionnaire to call your insurance before you come in.
- If we are providers for your insurance but you choose not to bill for the above reason, please fill out this form.
Acupuncture Northwest accepts the following insurance plans:
- Aetna: All providers (except Lucas Hedrick).
- Please note: As of January 1st, 2022, we will no longer be considered in network with the Aetna plans that are administered by American Specialty Health.
- Cigna: Out of network.
- First Choice:
- Matt Ferguson (Seattle/Tacoma)
- Stephanie Gianarelli (Seattle/Tacoma)
- Andrea Iwi'ula (Seattle/Bellevue).
- Humana, Molina or Medicare: Out of network.
- Kaiser Core: Matt Ferguson only.
- PIP (car accident insurance): All providers.
- Premera Blue Cross: All providers.
- Regence: All providers.
- Triwest: All providers (except Lucas Hedrick).
Costs without Insurance (Time of Service Discount)
90 Minute Initial Planting the Seeds Method Fertility Acupuncture Consultation and Treatment (includes a copy of the book, Planting the Seeds of Pregnancy, An Integrative Approach to Fertility Care): $250
90 Minute Initial Non-Fertility Acupuncture Consultation and Treatment: $165
45-60 Minute Return Acupuncture Appointment: $118
Acupuncture and Fertility Enhancement
Although we are credentialed with all of the major insurance plans in the State of Washington, at this time most insurance plans will not cover acupuncture for fertility enhancement. If you have acupuncture benefits with your insurance plan, we recommend that you check with your insurance plan before you come in to see if they will cover acupuncture for fertility enhancement or infertility.
As of January 2020, Regence has begun to call acupuncture for fertility a "non-covered charge" or a contract exclusion. Not only are they often not covering fertility acupuncture, they are also going back on previously covered visits and demanding that the patient now pay for these previously covered visits. And oftentimes we (as a provider's office) are not allowed to see a patient's contracted benefits so we are unable to tell upfront what will be covered and what won't be covered or covered and then taken back. We highly recommend that you call your insurance company before initiating treatment with our clinic and be aware that insurance companies sometimes change their minds on what they will cover.
Also, here is a July 23, 2015 letter from an insurance company denying a patient for fertility acupuncture:
“Your condition does not meet medical necessity criteria or guideline at the time because: Treatment to increase fertility is not considered medically necessary. Treatment to increase fertility is not treatment for a specific illness or injury; it is considered treatment primarily for your convenience. Treatment primarily for your convenience is not considered medically necessary. Fertility treatment is excluded from your acupuncture benefit and cannot be approved.”
Although we are more than willing to bill your insurance for issues outside of fertility, at this time, unless your insurance specifically allows for fertility acupuncture, we are unfortunately unable to bill your insurance. Feel free to call your HR department or your insurance and tell them how you feel about this.