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New Apple Health benefit for pain relief
As part of our commitment to whole-person care, Community Health Plan of Washington (CHPW) is offering a new and expanded Alternative Treatments benefit for all our Apple Health (Medicaid) members.
Effective 7/1/2022, CHPW will cover a combined 20 visits a year for acupuncture, chiropractic, and massage. Members don’t need a referral or prior authorization. They can seek treatment from any provider in Washington licensed to practice acupuncture, chiropractic, or massage.
Here are more details of the new benefit:
- CHPW is expanding this benefit coverage from an annual six-visit limitation for adults to up to 20 annual visits or combined with the other alternative treatment visits, for all ages.
- CHPW is adding this benefit coverage for adults,* allowing up to 20 annual visits or combined with the other alternative treatment visits.
- CHPW is adding this benefit coverage for all ages, allowing up to 20 annual visits or combined with the other alternative treatment visits.**
*Medicaid covers EPSDT chiropractic services for children up to age 20.
**Massage visits are based on session length of 30 minutes each. A one-hour massage, for example, would count as two visits.
Before providing the service, the provider can call CHPW Customer Service to check how many alternative treatment visits the patient has already made. CHPW will only reimburse up to the 20-visit annual limit, unless a Limitation Extension has been granted.
Please share this information with your clinic staff, including doctors, nurses, front desk staff, community health workers, social workers, and administrative staff.
How to bill CHPW
This benefit has an open provider network. Contracted providers should bill CHPW directly through the standard claims process. Non-contracted providers can bill CHPW by following the simple steps on this webpage: chpw.org/provider-billing. Look under the Alternative Treatments Billing Guideline heading for details on covered codes.
Alternatively, the client can pay up front and send the provider’s fully itemized bill to CHPW at the following address for reimbursement:
CHP Claims
PO Box 269002
Plano, Texas 75026-9002
The member can call Customer Service if they need help with submitting a reimbursement request.
What do acupuncture, chiropractic, and massage treat?
Medical studies show that alternative treatments help with some types of pain and other ailments. These include but are not limited to:
- Arthritis
- Dental pain
- Headaches, including tension headaches and migraines
- Anxiety and depression
- Fatigue (lack of energy or motivation)
- Low back pain
- Neck pain
- Menstrual cramps
- Muscle, bone, or joint pain
Who might want these treatments?
CHPW members may be especially interested in these benefits if any of the following apply to them:
- Experience chronic pain or stress
- Worried about opioid addiction
- Pregnant, hoping to become pregnant, or new parent
- Have migraines that aren’t responsive to medication
We’re very excited about this new and expanded benefit, and we want to work with you to help your patients get the treatments that are right for them. If you or your patients have questions about our Alternative Treatments benefit, call us at 1-800-440-1561 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m.
