GOOD FAITH ESTIMATE - MEDICARE
This Good Faith Estimate is intended to provide you with an estimate of the charges you'll incur at New Dawn Chiropractic and Acupuncture. Uninsured and self-pay clients are entitled to Good Faith Estimates as of January 1st, 2022 under the No Surprises Act.
Chiropractic
Good Faith Notice (MEDICARE)
Your chiropractic treatment will include an initial evaluation and a combination of treatments that may include spinal and extremity adjustments, manual therapy, electrical stimulation therapy, etc. If you have any questions about your upcoming appointment, please don't hesitate to reach out before your visit.
The first visit will range between $149 to $223 (depending on what is performed) for the evaluation and adjustments. Add-on services may be extra and not covered by Medicare.
Follow-up visits will range between $29 to $55 (depending on what is performed) for the adjustments. Add-on services may be extra and not covered by Medicare.
The number of visits will vary based on your particular symptoms and goals, which we will discuss during your evaluation.
We are in-network with Medicare but non-participating. What this means is we require payment upfront on the day of visit, but we will submit to Medicare on your behalf and they will reimburse you rather than us directly.
Clinic Treatment Codes / Units
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Initial Evaluation (99202): $120 (not covered by insurance)
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Initial Evaluation (99203): $168.30 (not covered by insurance)
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Re-Exam Evaluation (99212): $77 (not covered by insurance)
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Re-Exam Evaluation (99213): $121 (not covered by insurance)
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Spinal Adjustments to 1-2 areas (i.e. neck and upper back) (98940): $28.98
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Spinal Adjustments to 3-4 areas (i.e. neck, upper back, low back) (98941): $42.05
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Spinal Adjustments to 5+ areas (i.e. full body) (98942): $54.42
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Extremity Adjustments (i.e. wrists or knees) (98943): $34 (not covered by insurance)
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Manual Therapy (97140): $34 (not covered by insurance)
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Electrical Stimulation (97014): $28 (not covered by insurance)
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Ultrasound Therapy (97035): $34 (not covered by insurance)
We can not guarantee reimbursement from your insurance.
Acupuncture
Good Faith Notice
Your acupuncture treatment will include an initial evaluation and a combination of treatments that may include the use of acupuncture needles, manual therapy, electrical stimulation therapy, etc. If you have any questions about your upcoming appointment, please don't hesitate to reach out before your visit.
The first visit will be $150 for the evaluation and acupuncture. Add-on services may be extra.
Follow-up visits will be $90. Add-on services may be extra.
The number of visits will vary based on your particular symptoms and goals, which we will discuss during your evaluation. We offer a 10% “time of service” discount for those who pay the day of. This is usually described as a “cash rate” and for those not submitting to insurance. The numbers below are BEFORE the time of service discount.
Clinic Treatment Codes / Units
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New Patient Exam Fee: $60 (no insurance code and cannot be reimbursed by insurance *time of service discount included) OR Initial Evaluation (99202): $134 (if you have insurance coverage and would like to submit the exam fee to insurance)
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Acupuncture (97810 and 97811): $100
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Acupuncture with Electrical Stimulation (97810 and 97814): $123
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Cupping: $34 (as add-on) and $50 as a solo treatment
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Manual Therapy (97140): $34
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Electrical Stimulation (97014): $28
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Ultrasound Therapy (97035): $34
Acupuncture coverage is very limited. Sanford, (most) BCBSND, Medicare, and Medicaid DO NOT cover acupuncture.
We found some out-of-state BCBS and Federal BCBS cover some acupuncture. However, every plan is very different. If you wish for us to submit it to your insurance, we require the New Patient Exam Fee to be paid day of service. The services submitted to insurance will not include the time of service discount.
