One of the more troublesome questions faced by the no-fault practitioner may be stated as follows: what is the appropriate reimbursement rate for medically necessary services performed by a licensed acupuncturist? The answer to this query is undoubtedly made more difficult due to the fact that the Superintendent of Insurance has not adopted a fee schedule for acupuncture services performed by a licensed acupuncturist.
However, based upon two well publicized opinion letters by the Office of General Counsel of the Superintendent of Insurance issued in 2004 and the decisions of the Courts over the past three years, particularly the Appellate Term, Second Department, the answer to this question should be obvious: a no-fault insurer may use the workers’ compensation fee schedule for acupuncture services performed by chiropractors to determine the amount which a licensed acupuncturist is entitled to receive.
Legal Framework
