Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

Archived Coverage Decisions.

See Treatment Guidelines and Resources for additional information.

Revised: July 1, 2024: Title of Coverage Decision revised.

Acupuncture is the insertion of needles or lancets, with or without electrical stimulation, to directly or indirectly stimulate acupuncture points and meridians.

Conditions of Coverage:

The department covers acupuncture, with or without electrical stimulation, up to a maximum of 10 treatments over the lifetime of the claim, for:

• An accepted lumbar condition on the claim.

In addition, the following requirements must be met:

• Documentation of the referral from the attending provider must appear in the claim file, and
• The treatment provided must be only for covered conditions as stated in this policy, and
• The claim must be allowed and open.

Only the medically necessary number of acupuncture treatments should be provided, up to a maximum of 10 treatments over the lifetime of the claim.

Other Indications for Coverage

L&I will not authorize payment for acupuncture treatment related to conditions not listed in this or other medical coverage decisions.

Other Acupuncture Coverage Decisions

Acupuncture for Chronic Migraine and Tension-type Headache

Billing Codes

For billing information, please refer to L&I Fee Schedules and Payment Policies (MARFS).