Give it up already?

Raz Acupuncture, P.C. v AIG Indem. Ins. Co., 2010 NY Slip Op 51177(U)(App. Term 2d Dept. 2010)

It gets to the point where enough is enough.  The Appellate Term, Second Department, has repeatedly held that acupuncture services are reimbursable, as a matter of law, at the chiropractor rate.  The Court in the case stated the following:

“This court has held, “as a matter of law, that an insurer may use the workers’ compensation fee schedule for acupuncture services performed by chiropractors to determine the amount which a licensed acupuncturist is entitled to receive for such acupuncture services” (Great Wall Acupuncture, P.C. v Geico Ins. Co, 26 Misc 3d 23, 24 ). As it is undisputed that defendant paid plaintiff based upon the workers’ compensation fee schedule for acupuncture services performed by a medical doctor, a rate higher than that established for acupuncture services performed by a chiropractor, we decline to disturb so much of the order as granted defendant summary judgment dismissing plaintiff’s complaint with respect to those claims.”

What is somewhat new is that the Appellate Term has held that the “it is not compensable” defense for failing to pay an initial acupuncture visit shares the same level of validity as the “it is included in the comprehensive visit” defense for failing to pay for computerized range of motion.  For those of you who do not get this sardonic humor, it is sufficient to say that there is no validity to this statement.

Related Articles

• NY Acupuncture Fee Schedules: Licensed Practitioners Limited to Chiropractor Rates
• NY Acupuncture Prima Facie Defense: Chiropractor Rate Limitations Upheld
• Fee Schedule Defense Requirements in No-Fault Insurance Cases
• Understanding Medical Billing and Down-Coding in New York No-Fault Insurance Claims
• New York No-Fault Insurance Law

Legal Update (February 2026): The fee schedules and reimbursement rates for acupuncture services referenced in this 2010 post have been subject to multiple regulatory updates and amendments since publication. Practitioners should verify current fee schedule provisions and any changes to the workers’ compensation fee schedule structure that may affect acupuncture reimbursement rates under no-fault insurance policies.