Acupuncture - Pilot Project

Pilot Requirements

We are no longer accepting applications for pilot providers.

Qualified participating providers will include:

  • East Asian Medicine Practitioners (EAMPs) licensed through the Washington State Department of Health who also complete and submit a non-network Provider Account Application.
  • Participating Medical Provider Network (MPN) providers (MD/DO) that have an individual L&I provider number.

In addition, there are specific requirements that a potential provider must agree to in order to participate in the acupuncture pilot project.

Authorization requirements

Prior authorization from the claim manager is not required.

Ongoing treatment, for low back pain related to an accepted condition on a workers' compensation claim, is approved up to 10 acupuncture visits over the lifetime of the claim. The attending provider must refer the worker for acupuncture treatment in order for such treatment to be paid by the insurer as part of the pilot.

Documentation requirements

Under workers' compensation insurance, acupuncture treatment for low back pain related to an accepted condition on an open workers' compensation claim must focus on helping occupationally injured and ill workers heal and return to work. We require documentation that gives claim managers the information they need to make timely and fair decisions.

All reports must be legible, preferably electronic, and in a style that can be understood by non-medical personnel.

Each report must contain at least the following:

  • Summary of subjective complaints.
  • Objective findings.
  • Treatment plan focusing on functional improvement.
  • Assessment of functional status using Oswestry Disability Index (ODI) and 2-item Graded Chronic Pain Scale (GCPS) at baseline, middle/fifth visit, and end of treatment.
  • At final visit, report must also include reason for discharge.

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