Key Takeaway
Flushing Traditional's 2013 code 99202 claim survived dismissal, but neither side won summary judgment on it. The initial-visit distinction.
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.
An initial-evaluation claim remained in the case because GEICO had not addressed it. That is narrower than a ruling that an acupuncturist was entitled to payment at a particular rate.
Historical note: The unresolved 2013 evaluation claim is not a present-day rate rule; DFS identifies later acupuncture schedules and the October 2020 service-date boundary.
Last reviewed: September 2026. Original publication date retained.
Neither side won the 99202 claim
In Flushing Traditional Acupuncture v GEICO, 2013 NY Slip Op 51538(U), the insurer established its older chiropractor-schedule defense for codes 97813 and 97814. It did not establish a basis to dismiss the initial evaluation billed under code 99202.
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But the provider’s own motion also failed on that claim: its affidavit did not establish the required facts about the denial. The Appellate Term therefore left the evaluation claim unresolved rather than directing payment.
The court did not answer the archive’s question about the proper rate. For later services, the provider category, schedule edition and billing record need their own review. A motion that overlooks one charge does not itself prove that charge is payable.
Historical commentary from the archive
The archive’s original commentary overstates the result. The claim remained unresolved; the provider did not receive a payment award or a determination of an initial-visit rate:
The court has now explicitly held that a medical provider is entitled to bill for an initial acupuncture visit.
So the open question is whether an acupuncturist is entitled to the chiropractor rate for an initial visit and other rendered services?
I sense the answer is yes,
Connect to the Encyclopedia
- Fee-schedule defense hub: cases, proof and later developments
- Forrest Chen: comparison rates and the unpreserved argument
- Acupuncture Approach: 97039 survived, other claims did not
- 2 & 9 Acupuncture: the unresolved 97026 and 97016 claims
- Bronx Acupuncture: by-report verification and the motion result
For review of a particular no-fault billing dispute, contact our office.
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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