In no-fault insurance, fees for almost all services are governed by the Workers’ Compensation Fee Schedule. However, because acupuncture treatment rendered by a licensed acupuncturist, while covered under no-fault,1 is not reimbursable under Workers’ Compensation insurance, such is not addressed in the fee schedule. Accordingly, for years, acupuncturists treating no-fault patients were permitted to bill the prevailing fee in the geographic location of the provider.2 Such charges were commonly $75 to $125 per treatment.
Then in 2007, the Appellate Term, Second Department, in Great Wall Acupuncture v. GEICO General Ins. Co.,3 relying on an opinion letter of the New York State Insurance Department,4 determined that insurers may reimburse acupuncturists at $29.30 per treatment, the same amount that chiropractors are entitled to for acupuncture services provided. Over the next three years, scores of appellate cases addressed nuances in the Great Wall decision, but all determined that acupuncturists should be reimbursed at the chiropractic rate.
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