The 15 minute increment of time is defined as personal one-on-one contact with the patient. This means that the physician acupuncturist is in the room with the patient, is actively performing a medically necessary activity that is a component of acupuncture or electro acupuncture. The time that the needles are retained is specifically excluded for the purpose of determining time and consequently from reimbursement. 8 Minute Rule for Timed Codes – One Service
For services billed in 15-minute units, count the minutes of skilled treatment provided. Only direct, face-to-face time with the patient is considered for timed codes. 8 minute time rule for timed service
• 7 minutes or less of a single service is not billable.
• 8 minutes or more of a single service is billable as 1 unit or an additional unit if the prior units were each furnished for a full 15 minutes:
• 8 – 22 minutes = 1 unit
• 23 – 37 minutes = 2 units
• 38 – 52 minutes = 3 units
• 53 – 67 minutes = 4 units
The face-to-face time can be identified as pre-service work which includes greeting the patient and a brief interval history. Intra-service work for actions connected to the acupuncture procedure which may include pertinent evaluation and assessment of the patient (tongue, pulse, palpation, ROM etc.), hand washing, patient positioning, locating and cleaning the points, inserting and stimulating the needles, checking on the patient, removing the needles, and any discussion or counseling related to the acupuncture service. The face-to-face time does not include needle retention time where there is no need for direct patient monitoring or contact.