Did VA / Medicare Allowed Rates Increase?
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Did VA / Medicare Allowed Rates Increase?
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About this listen
There's great news for acupuncturists billing Medicare and the VA: for 2025, there's been a substantial increase in the allowed rates for the initial acupuncture codes, 97810 and 97813. This significant change, described as roughly a 20% increase and the largest change to any code value for 2025, stems directly from increases in the Relative Value Units (RVUs) for these codes. VA rates are specifically tied to Medicare rates.
This positive shift impacts not only Medicare and VA claims but also other plans in states that utilize RVUs to determine their fee schedules, such as certain worker's compensation and personal injury plans. While the RVUs for subsequent sets (97811, 97814) decreased, the overall impact is still an aggregate increase in reimbursement. The key takeaway is to always bill your regular rate to ensure you receive the maximum allowed amount, and to stay informed about these important updates.