Oregon Health Plan - Acupuncture Coverage
Due to limited government funding, Oregon Health Plan, Oregon's Medicaid, covers only a limited list of medical conditions for acupuncture treatments. A referral is needed from your Primary Care Physician (PCP) with the qualified diagnosis to our office using the ICD-10 Diagnoses Codes listed below for acupuncture coverage.
*OHP coordinated by Providence Health Plan needed your PCP to submit to the insurance first for approval before services can be render. Please submit referral through Providence Health Plan ProvLink Provider Portal.
*OHP coordinated by CareOregon needed PCP to submit the referral with the diagnoses to our office, can be faxed to 503-972-1849. Authorizations can also be submitted through CareOregon Connect.
As of 01/01/2021, OHP funding covers Line 1 through Line 469 of the Prioritized List of Health Services.
*OHP coordinated by Providence Health Plan needed your PCP to submit to the insurance first for approval before services can be render. Please submit referral through Providence Health Plan ProvLink Provider Portal.
*OHP coordinated by CareOregon needed PCP to submit the referral with the diagnoses to our office, can be faxed to 503-972-1849. Authorizations can also be submitted through CareOregon Connect.
As of 01/01/2021, OHP funding covers Line 1 through Line 469 of the Prioritized List of Health Services.
2021 OHP Acupuncture Coverage (ICD-10 Diagnoses Codes)
PREGNANCY RELEATED:
O21.0, O21.1, O32.1, O99.89
DEPRESSION (POST-STROKE DEPRESSOIN ONLY):
F32.0-F32.1, F32.8, F33.8, F34.0, F34.8, F39, N94.3
SCOLIOSIS:
M41.00-M41.08, M41.112-M41.9, M96.5, Q67.5, Q76.3, Z47.82
CONDITIONS OF THE BACK AND SPINE:
F45.42, G83.4, G95.0, M24.08, M25.78, M40.00-M40.15, M40.202-M40.57, M42.00-M42.09, M42.11-M42.9, M43.00-M43.4, M43.5X2-M43.9, M45.0-M45.9, M46.1, M46.40-M46.99, M47.011-M47.9, M48.00-M48.38, M48.8X1-M48.9, M49.80-M49.89, M50.00-M50.93, M51.04-M51.9, M53.2X1-M53.9, M54.00-M54.9, M62.830, M96.1-M96.4, M99.00-M99.09, M99.20-M99.79, M99.81-M99.84, Q06.0-Q06.3, Q06.8-Q06.9, Q76.0-Q76.2, Q76.411-Q76.49, S13.0, S13.4, S13.8, S13.9, S16.1, S23.0-S23.171, S23.3, S23.8, S23.9, S33.0-S33.9, S34.3, S39.092, S39.82, S39.92
MIGRAINE HEADACHES:
G43.0, G43.1, G43.5, G43.7, G43.8, G43.9
OSTEOARTHRITIS (KNEE ONLY):
M17
*Note: Medicare does not have acupuncture coverage.
PREGNANCY RELEATED:
O21.0, O21.1, O32.1, O99.89
DEPRESSION (POST-STROKE DEPRESSOIN ONLY):
F32.0-F32.1, F32.8, F33.8, F34.0, F34.8, F39, N94.3
SCOLIOSIS:
M41.00-M41.08, M41.112-M41.9, M96.5, Q67.5, Q76.3, Z47.82
CONDITIONS OF THE BACK AND SPINE:
F45.42, G83.4, G95.0, M24.08, M25.78, M40.00-M40.15, M40.202-M40.57, M42.00-M42.09, M42.11-M42.9, M43.00-M43.4, M43.5X2-M43.9, M45.0-M45.9, M46.1, M46.40-M46.99, M47.011-M47.9, M48.00-M48.38, M48.8X1-M48.9, M49.80-M49.89, M50.00-M50.93, M51.04-M51.9, M53.2X1-M53.9, M54.00-M54.9, M62.830, M96.1-M96.4, M99.00-M99.09, M99.20-M99.79, M99.81-M99.84, Q06.0-Q06.3, Q06.8-Q06.9, Q76.0-Q76.2, Q76.411-Q76.49, S13.0, S13.4, S13.8, S13.9, S16.1, S23.0-S23.171, S23.3, S23.8, S23.9, S33.0-S33.9, S34.3, S39.092, S39.82, S39.92
MIGRAINE HEADACHES:
G43.0, G43.1, G43.5, G43.7, G43.8, G43.9
OSTEOARTHRITIS (KNEE ONLY):
M17
*Note: Medicare does not have acupuncture coverage.