Key Takeaway
Kings County judge reversed again for rejecting Great Wall acupuncture fee schedule ruling. Appellate Term upholds chiropractor rate limitations for acupuncture services.
Ema Acupuncture, P.C. v Geico Ins. Co., 2014 NY Slip Op 50415(U)(App. Term 2d Dept. 2014)
Not sure why Kings County is the only venue where Great Wall does not apply and a substitute peer gets knocked out of the box, save 2-3 judges, despite the legion of caselaw which says otherwise. Add the briefing schedule which is the ultimate technicality and you have pure entropy. How many times has a plaintiff or a defendant been prejudiced due to a violation of the briefing schedule?
I digress for good reason. Here, the Court refused to comply with Great Wall. And once again, the Appellate Term says otherwise.
(1) “As to plaintiff’s remaining claims, defendant demonstrated that it had fully paid plaintiff for those services in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 ). In opposition, plaintiff relied upon an affirmation from plaintiff’s counsel which failed to establish the existence of a triable issue of [*2]fact.”
(2) “Defendant did not raise any issue warranting the dismissal of plaintiff’s claim for $154.29 for the initial acupuncture visit on January 6, 2009, billed for under fee schedule treatment code 99205”
(3) “Defendant’s contention that plaintiff is barred from recovering attorney’s fees with respect thereto pursuant to Insurance Department Regulations (11 NYCRR) § 65-4.6 (i) lacks merit.”
(LMS Acupuncture, P.C. v Geico Ins. Co., 2014 NY Slip Op 50416(U)(App. Term 2d Dept. 2014))
Related Articles
- NY Acupuncture Fee Schedules: Licensed Practitioners Limited to Chiropractor Rates
- NY Acupuncture Prima Facie Defense: Chiropractor Rate Limitations Upheld
- Civil Court JHO “Reversing” Appellate Division Holdings in No-Fault Cases
- Fee Schedule Defense Requirements in No-Fault Insurance Cases
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2014 post, New York’s no-fault fee schedules and reimbursement regulations have undergone multiple revisions, including potential amendments to regulation § 65-4.6 and updates to workers’ compensation fee schedule cross-references. Practitioners should verify current fee schedule provisions and recent appellate decisions regarding Great Wall precedent applicability, as both regulatory frameworks and judicial interpretations may have evolved significantly over the past decade.
