Insurance Companies We Work With

---

Navigating health‑insurance rules can be confusing, so we are here to help clarify information for you. Our team will be available to answer questions and design treatment plans that protect both your health and your budget.  

Insurance & Acupuncture Benefits

At this time, we do not accept Medicaid, OHP, or Medicare as a Primary.

We’ll gladly help you check acupuncture benefits and explain what we find in plain language. Benefit verification is an estimate, not a guarantee of coverage or payment. Your insurer makes the final decision, and benefits can change.

Because we’re mixed network (in-network with some plans and out-of-network with others), what you pay depends on your specific plan and our network status.

If we’re IN-NETWORK with your plan:
You’re responsible for your plan’s patient-responsibility amounts (copay, coinsurance, deductible) and any non-covered services.

If we’re OUT-OF-NETWORK with your plan:
You may have higher out-of-pocket costs or you may be responsible for the full charge at the time of service, depending on your plan. Some plans reimburse you after you submit a claim. We can provide documentation (like a superbill) when appropriate.

What we can do:

• Verify benefits when possible and share what we learn
   
• Help you understand deductibles, visit limits, and authorization requirements
   
• Provide an estimate based on available info
   

What you’re responsible for confirming:

• Eligibility and effective dates
   
• Deductible status and remaining deductible
   
• Copay/coinsurance amounts
   
• Visit limits and exclusions
   
• Referral and/or prior authorization requirements

We can’t promise exact costs until your insurer processes the claim.

Important note about “surprise billing” protections:
State and federal laws protect patients from certain surprise bills in specific situations (typically emergency care or certain facility-based care). 

We use the following codes to bill your insurance:

99202 -  Office Visit NP 1 DDX Focused 10 minutes

97810 -  Acupuncture, Initial 15 minutes

97811 -  Acupuncture, Each Additional 15 minutes/unit

97813 -  Acupuncture w Electrical Stimulation Initial 15 minutes 

97814 -  Acupuncture w Electrical Stimulation Each Additional 15 minutes/unit

97140 -  Myofascial Release (15 minutes/unit) 

97110 -  Neuromuscular Exercises, 1 or more areas, each 15 minutes

97112 -  Neuromuscular Re-Education, 1 or more areas, each 15 minutes

Please note that most copays or co-insurance payments only covers acupuncture codes. For nearly all sessions,  our clinicians provide manual therapy (sports massage, myofascial release, therapeutic exercises, fire cupping) which will increase your patient responsibility beyond your copay/co-insurance amount. If you have concerns about your bill, please make sure you alert the provider ahead of time. We make every effort to keep bills as minimal as possible while also providing you our full scope of services and care.

Anjuna Sports Acupuncture does not currently provide secondary billing services. If you are double covered, we will happily provide you with a superbill so you can bill your secondary insurance.

Under Oregon Workers’ Compensation rules, acupuncture and therapeutic massage are reimbursable services. Licensed acupuncturists are authorized providers, with benefits capped at 18 visits or 60 days—whichever comes first. Most claims are paid at 100 % once these conditions are met: your employer has been notified of the work‑related injury, the required injury reports are filed, your employer carries Workers’ Compensation coverage, and the claim is formally accepted. Costs not covered—such as supplements or herbal formulas—are the patient’s responsibility at the time of purchase. Because individual plans may impose additional requirements, consult your claims adjuster or HR department to confirm that treatment at Anjuna is approved.

Anjuna Medicine is not contracted with Original Medicare or the Oregon Health Plan (Medicaid) and therefore cannot accept assignment from those programs. Original Medicare currently limits acupuncture coverage to chronic low‑back pain—up to 20 visits per year when provided by specific physician‑qualified practitioners—so most services in our clinic fall outside that benefit.

Many Oregon Medicare Advantage (Part C) plans, however, include broader acupuncture benefits. For example, PacificSource Medicare Advantage follows the 20‑visit annual limit with a typical $25 copay, and other carriers (e.g., Humana, AllCare, CareOregon) list acupuncture among their complementary‑care options.

If you have a Medicare Advantage plan, check your policy for out‑of‑network coverage, visit caps, and copay requirements; we can provide detailed receipts to help you seek reimbursement. You remain financially responsible for any portion not covered by your plan.

Oregon’s Personal Injury Protection (PIP) statute (ORS 742.520 – 742.524) requires every auto policy to provide at least $15,000 for “reasonable and necessary” medical care incurred within two years of a crash. That benefit is truly no‑fault: it applies to the driver and every passenger, and it can be used for treatment by licensed acupuncturists and massage therapists, with no referral required. Policy limits can be higher and some carriers impose additional administrative steps, so confirm the details with your claims adjuster. If losses exceed PIP or liability is contested, any personal‑injury lawsuit must be filed within two years of the accident under Oregon’s statute of limitations.

Payment in full is due at the time of your appointment. If you need alternative financial arrangements, please contact our customer support team before your scheduled visit.