Acupuncture Pilot Project FAQ
1. What is the L&I Acupuncture Pilot Project?
The Acupuncture Pilot Project will collect information to inform the provision of acupuncture treatment for low back pain, including acupuncture provided by East Asian Medicine Practitioners (EAMPs), to injured or ill workers covered by Washington’s workers’ compensation system. This project provides a structured environment for care delivery and capture of data that will inform future L&I coverage and payment methodology for acupuncture. While the project is underway, the Department of Labor & Industries (L&I) will pay qualified providers participating in the pilot project to deliver acupuncture treatment to injured workers with low back pain related to an accepted condition on an open workers’ compensation claim.
2. How long will the pilot run?
The pilot will run for up to two years, from 2017 to 2019.
3. Who is qualified to participate in the pilot?
a. East Asian Medicine Practitioners (EAMPs) licensed through the Washington State Department of Health who also complete and submit a non-network Provider Account Application.
b. Participating Medical Provider Network (MPN) providers (MD/DO) that have an individual L&I provider number.
4. Can all injured workers receive acupuncture treatment?
No, the following conditions must be met in order for an injured worker to receive acupuncture treatment.
a. The treatment must be for low back pain related to an accepted condition on an open workers’ compensation claim.
b. The acupuncture treatment will be reimbursed only when referred by the worker's attending provider.
5. What kinds of services are covered in the pilot program?
a. Acupuncture treatment, for low back pain related to an accepted condition on a workers’ compensation claim only, is covered up to a maximum of 10 visits per injured worker’s claim. Providers are expected to continue treatment only if clinically meaningful improvement is documented midway through treatment. Only the medically necessary number of acupuncture treatments should be provided.
b. Other treatment modalities within EAMPs’ scope of practice are not covered under this pilot, and will not be separately reimbursed. Please note that to provide acupuncture, you must accept L&I’s payment as sole and complete remuneration for services provided to the worker as required by Washington State law (no balance-billing is allowed).
Learn more at http://lni.wa.gov/ClaimsIns/Providers/TreatingPatients/ByCondition/Acupuncture/default.asp