Acupuncture outpatient services are limited to two services in a month, in combination with audiology, chiropractic, occupational therapy, and speech therapy services (limits do not apply to children under 21). Acupuncture services are limited to treatment performed to prevent, modify or alleviate the perception of severe, persistent chronic pain resulting from a generally recognized medical condition. Authorization is not required for acupuncture services for up to two visits per month. Prior authorization is required if additional visits are needed through ASH (see below for link) during the same month.

Medi-Cal members may self-refer for acupuncture (first two services per month) for certain conditions, illnesses or injuries only covered in conjunction with services from a medical doctor (for example, chronic pain or nausea related to chemotherapy). Additional appointments require referral.

Participating physician groups (PPGs) and direct network providers must only refer Medi-Cal members to ASH Plans for acupuncture services.

This is not applicable to Health Net members assigned to Molina. Contact Molina about acupuncture services.