Updated Alternative Treatments Billing Guideline for CS Plans - Washington State Local Health Insurance - CHPW
Community Health Plan of Washington Apple Health Medicaid Plan Community Health Plan of Washington Apple Health Medicaid Plan

Updated Alternative Treatments Billing Guideline for CS Plans

Cascade Select members have access to acupuncture, chiropractic, and naturopathic services for all ages.

Download: Alternative Treatments Billing Guideline – Cascade Select

Services are subject to benefit coverage, limitations, and exclusions as described in plan coverage guidelines. Review the Benefit Grids for limitations. The Individual & Family Cascade Select Plans have different cost shares between the plans.

Members must go to a contracted provider who is certified to provide these services within the scope of their license.

Covered Codes

The following codes are covered.

  • Covered E&M services do not count toward the benefit limit.
  • For chiropractic and acupuncture services, there is a limit of one E&M visit per year.

Covered Codes

The following codes are covered for the Alternative Treatment Benefits.

Chiropractic medicine Covered codes
E&M Covered effective for dates of service 01/01/2024 and after: 99202 | 99203 | 99212 | 99213  (Not covered through 12/31/2023)
Manipulation 98940 | 98941 | 98942
X-rays  70000 – 79999
Acupuncture Covered codes
E&M Covered effective for dates of service

01/01/2025 and after: 99202 | 99203 | 99212 | 99213  (Not covered through 12/31/2024)

Procedures 97810 | 97811 | 97813 | 97814
Massage therapy Not covered
Naturopath Covered codes
E&M Appropriate CPT code for the service.

*The rate for reimbursement is based on the CMS physician fee schedule for the appropriate area: 02 for King County or 99 for all other counties.

Questions?

If you or your patient have any questions, our Customer Service Team is ready to help. You can email [email protected] or call during business hours.

  • Phone number: 1-866-907-1906
  • Business hours: Monday through Friday from 8:00 a.m. to 5:00 p.m.

 

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