Key Takeaway
Precious Acupuncture v Hereford: the coder affidavit supporting no-fault fee payment and the distinction between preserving a defense and proving it.
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.
This was a no-fault reimbursement action, not a workers’ compensation claim. In Precious Acupuncture v Hereford, 2018 NY Slip Op 50042(U), decided January 12, 2018, the court accepted a certified coder and biller’s affidavit explaining payment under the workers’ compensation fee schedule.
Historical note: Precious Acupuncture (2018) accepted this affidavit under the post-2013 rule; Burke (2026) illustrates why a nonprecluded fee defense may still require trial proof.
Last reviewed: September 2026.
The record that supported dismissal
The five claims concerned services from December 2013 through April 2014. The insurer’s affidavit established full payment under the schedule. The provider submitted only an attorney affirmation without demonstrated personal knowledge and failed to raise a triable issue. The Appellate Term, Second Department, reversed the provider’s judgment and granted the insurer summary judgment.
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The court also applied the excessive-fee amendment effective April 1, 2013: the insurer did not have to establish a timely denial to preserve this defense. Preservation and proof are different. A surviving defense still needs evidence supporting the charge calculation; a coding credential alone does not establish it.
Later decisions require care about court and posture
Blano Medical v Hereford (2025), a Kings County Civil Court decision, rejected an attempt to raise an undenied fee defense at trial. It is a contrary trial-level treatment, not an appellate overruling of Precious Acupuncture.
In Burke Physical Therapy v National General (2026), that court treated the fee defense as nonprecluded on four claims but left its merits for trial. Neither decision makes the existence of a coder’s affidavit an automatic win.
Jason’s original shorthand
Read Jason’s original sentence as a reaction to this record, not a rule that certification alone proves every fee defense:
Workers compensation fee schedule defense is satisfied through the affidavit of a certified medical coder.
Connect to the Encyclopedia
Start with the fee-schedule defense hub. Related case notes:
- Urban Well: coding corrections and separate necessity proof.
- OS Tigris: an unsupported fee-schedule defense.
- Great Wall: the November 2009 trial record.
- Live In Grace: the electrical-stimulation codes 97813 and 97814.
- Excel Surgery: New Jersey treatment and the service date.
- Healing Art: agreed coder testimony on codes 97810 and 97811.
- Quality Comprehensive: fee proof supported only partial dismissal.
- Acuhealth: the missing by-report verification request.
For review of a particular no-fault billing dispute, contact the Law Office of Jason Tenenbaum. Bring the bill, service dates, denial and payment calculation.
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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