CHPW Alternative Treatment Payment Guide

Posted on May 22nd, 2023 in Bulletin Board by Corey Youngknutsen

Get paid for acupuncture, chiropractic, massage, or naturopathy services you perform for Community Health Plan of Washington (CHPW) members—even if you’re not in our network.

Who we are

CHPW has been providing access to quality health care to the people of Washington since 1992. We work hand in hand with our communities to make it as easy as possible for them to get the care they want and need.

CHPW’s open network: you provide it, we pay for it

CHPW covers alternative services under an open network. That means we pay for treatments our Apple Health and Medicare Advantage members receive under these conditions:

• The service falls under our Alternative Treatments umbrella of acupuncture, chiropractic, massage, or naturopathy.
• The person who provides the service has the appropriate Washington license.
• Members do not need a referral from their regular doctor to use these services, and their provider does not necessarily have to contract with us.*

*CHPW’s Individual & Family Cascade Select members must receive their covered acupuncture and chiropractic services from an in-network provider.

Join CHPW’s Network

We’d love to welcome you to our network of committed providers. Joining is simple.

Just fill out our online form, and we’ll be in touch within 30 days: chpw.org/provider-center/join-our-network

Frequently Asked Questions

How do I get paid for a service I’ve given?

Follow the easy claims process on our website:
chpw.org/provider-center/provider-training-and-resources/provider-billing-and-claims/

Because of our open network, we will accept claims from any licensed provider. (In Washington state.)

Is there a limit to the number or type of visits CHPW will cover?

CHPW coverage for Alternative Treatments varies between plans:

Apple Health: Combined 20 visits per year for acupuncture, chiropractic, and massage therapy

Medicare Advantage Plan 2 and Dual Plan (D-SNP): Combined 25 visits per year for acupuncture, non-Medicare covered chiropractic, massage therapy, and naturopathy

All other Medicare Advantage plans: Combined 12 visits per year for acupuncture, non-Medicare covered chiropractic, and naturopathy

Note: Because this coverage is for a combined number of visits across all treatment types, members may see you in addition to other Alternative Treatment providers to support their overall health.

What if a CHPW member pays me out of pocket?

We encourage you to bill us on behalf of CHPW members. If you have questions about claims or billing, please contact Customer Service at 1-800-440-1561.

Members who pay for Alternative Treatments out of pocket go through a separate reimbursement process. CHPW Customer Service can help them do this, or you can share this PDF: chpw.org/alt-treatment-form

Benefit Procedure Codes