Key Takeaway
NY acupuncture reimbursement case: Appellate Term rules on proper billing codes 97810, 97811 and initial consultation fees under no-fault insurance law.
This article is part of our ongoing fee schedule coverage, with 118 published articles analyzing fee schedule issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Olga Bard Acupuncture, P.C. v Geico Ins. Co., 2010 NY Slip Op 51898(U)(App. Term 2d Dept. 2010)
This is an interesting case because the Appellate Term actually listed two of the four properly used acupuncture codes, and discussed an initial consultation code. These codes involved: 97810, 97811 and an initial consultation code.
“Consequently, so much of plaintiff’s motion as sought summary judgment on the second and third causes of action as well as the remaining portion of the first cause of action should have been denied, and so much of defendant’s cross motion as sought summary judgment dismissing the second and third causes of action and the remaining portion of the first cause of action should have been granted, as these causes of action sought to recover upon claims that were paid pursuant to the workers’ compensation fee schedule (see Great Wall Acupuncture, P.C., 26 Misc 3d 23; Great Wall Acupuncture, 16 Misc 3d 23).”
Therefore, “so much of plaintiff’s motion as sought summary judgment as to the second and third causes of action and as to claims bearing codes 97810 and 97811 included in the first cause of action is denied, so much of defendant’s cross motion as sought summary judgment dismissing the second, third, fourth and fifth causes of action as well as so much of the first cause of action as sought to recover for claims bearing codes 97810 and 97811 is granted…”
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“However, defendant did not proffer sufficient evidence to warrant the dismissal of plaintiff’s claim in the sum of $109.34 for the initial acupuncture visit, which claim was included in plaintiff’s first cause of action”
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Legal Update (February 2026): Since this 2010 post, New York’s no-fault fee schedules and acupuncture reimbursement provisions have been subject to multiple regulatory amendments and updates. The specific CPT codes, reimbursement rates, and fee schedule methodologies referenced in this case may no longer reflect current law. Practitioners should verify current fee schedule provisions and applicable reimbursement rates with the most recent regulatory guidance.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Fee Schedule Issues in No-Fault Insurance
The New York no-fault fee schedule establishes the maximum reimbursement rates for medical treatment provided to injured motorists. Disputes over fee schedule calculations, coding, usual and customary charges, and the applicability of workers compensation fee schedules to no-fault claims are common. These articles analyze fee schedule regulations, court decisions on reimbursement disputes, and the practical challenges providers face in obtaining appropriate payment under the no-fault system.
118 published articles in Fee Schedule
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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