Key Takeaway
S.O.V. granted partial dismissal of 2015–2016 acupuncture claims. Read the code and service-date exceptions and the later fee-schedule boundary.
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.
S.O.V. Acupuncture v Global Liberty (2020) granted partial dismissal of claims for 2015–2016 services. Its discussion of chiropractic rates concerned a comparison schedule for the acupuncture claims at issue, not a ruling about a chiropractor’s authority to perform acupuncture.
Legal Update (September 2026): DFS’s schedule guidance distinguishes services before and after October 1, 2020; S.O.V.’s 2015–2016 claims belong to the earlier period.
Last reviewed: September 2026
Which fee claims were dismissed
The insurer established full schedule payment for CPT codes 97810, 97811, 99202 and 99212. It also proved payment for code 97026, except for services on December 11, 2015, and March 1, 17 and 28, 2016. Those exceptions matter: the court did not grant a clean sweep of the complaint.
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Other claims remained because the insurer’s coder conceded that the insurer had not shown a right to dismissal. The opinion is useful for reading the proof claim by claim, not for assuming that a successful rate argument resolves every billed service.
The other grounds were separate
The court also granted dismissal on an IME nonappearance ground and dismissed a late-submitted claim. On the latter, the denial contained notice that the provider could offer reasonable justification for the delay. The mailing discussion relied on the address in the sworn NF-2 in this record.
Those findings do not eliminate the need to prove scheduling, mailing or claim timeliness in a different action. Nor does the decision establish that every current acupuncture code must use an old chiropractic comparison rate. Jason’s anticipation of the approaching schedule change is preserved below.
Jason’s historical commentary
Jason’s original reaction anticipated the approaching schedule change. It should not be read as saying that older service dates stopped mattering:
Well in a few weeks and to the extent people still treat for motor vehicle accidents, this will be placed in the New York no-fault relic garbage can.
Connect to the Encyclopedia
Fee-schedule defense topic hub
- Okslen: the earlier physician-rate ceiling
- Raz: separating treatment claims from an initial visit
- Oriental World: proof of payment under Great Wall
- LVOV: what a coder affidavit established
- First Aid: bundling claims left for trial
For review of a particular bill or denial, contact the firm. The decision and commentary above concern the stated record; they do not determine a new claim.
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.
If you need legal help with a fee schedule matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
