Restored Outpatient Acupuncture Services for FQHC and RHC Providers
Effective retroactively for dates of service on or after July 1, 2016, outpatient acupuncture services for Federally Qualified Health Center and Rural Health Clinic (FQHC/RHC) providers are restored as acupuncture benefits provided to Medi-Cal recipients.
The following per-visit billing codes are restored (for dates of service through September 30, 2017):
| Code | Description |
| 01 | Medi-Cal per-visit code |
| 15 | Acupuncture |
| 18 | Managed care differential rate |
Affected claims for dates of service on or after July 1, 2016, will be reprocessed with an Erroneous Payment Correction (EPC).
The following HIPAA-compliant code sets are available for billing on or after October 1, 2017:
| Revenue Code | Procedure Code | Modifier | Description |
| 0521 | T1015 | N/A | Medical Visit |
| 2101 | 97810 | SE | Acupuncture Services |
| 2101 | 97811 | SE | Acupuncture Services |
| 2101 | 97813 | SE | Acupuncture Services |
| 2101 | 97814 | SE | Acupuncture Services |
| 0521 | T1015 | SE | Managed Care Differential Rate |
Providers will receive a 90 day timeliness override, effective the date of this publication, for billing acupuncture services for the dates of service described above.
For more information, visit California Department of Health Care Services.
