Most people assume that if insurance “covers” acupuncture, providers are paid fairly.

In California, acupuncturists are locked into take-it-or-leave-it rates—most commonly $41 per 15-minute unit, with lows around $35—set by third-party administrators. Saying no means losing access to nearly all insured patients. And if you do go in-network, you’re also forced to keep your cash rates artificially low under “most favored nation” clauses and other contractual limits, making it nearly impossible to offset the losses with private-pay patients.

 

 

In 2017, more than 1,200 people signed a petition calling for an investigation into American Specialty Health’s underpayment of California acupuncturists.

 

Eight years later, nothing has changed — rates remain stuck at $42–$49 per session, third-party administrators still dictate fixed fees without negotiation, and the profession continues to be classified as “Complementary and Alternative Medicine” despite being recognized as primary care in California law.

 

This petition demands immediate action from the California Acupuncture Board, the Legislature, the Department of Managed Health Care, and the insurance industry to end a decade of economic stagnation and bring Licensed Acupuncturists to pay parity with other healthcare providers.

 

Licensed Acupuncturists in California provide state-recognized primary care services, yet our insurance reimbursement rates have been stagnant at near minimum-wage rates for over a decade...

 

For example, American Specialty Health (ASH) — the largest third-party administrator (TPA) managing acupuncture benefits for insurers such as Cigna, Anthem, and UnitedHealthcare — reimburses most contracted providers between $42 and $49 per session, regardless of length, complexity, or number of units billed.

Zelis and other TPAs apply similar fixed-fee structures.

These rates have not increased in over 10 years, despite rising operating expenses and the professional obligations we must meet to legally practice and bill insurance:

 

1. Licensure Renewal – $500 every two years.
2. Continuing Education – 50 units every two years, at the licensee’s expense.
3. Malpractice Insurance – Required to practice and bill insurers.
4. Overhead Costs – Rent, utilities, supplies, administrative support, and technology.

When adjusted for inflation, these stagnant payments represent a significant real-dollar pay cut — reducing the economic viability of our profession year after year.

 
This Is Not a New Problem:

 

Eight years ago, more than 1,200 people signed a petition calling for an investigation into American Specialty Health’s underpayment of California acupuncturists. Nothing has changed. Rates remain stagnant, third-party administrators dictate fees without negotiation, and the profession is still classified as “Complementary and Alternative Medicine” despite being recognized as primary care under California law.

 

Meanwhile, acupuncturists carry the same professional burdens as other primary care providers:

 

 

American Specialty Health (ASH)—the largest third-party administrator (TPA) managing acupuncture benefits for insurers such as Cigna, Anthem, and UnitedHealthcare—controls access to vast patient pools. Zelis and other TPAs use similar fixed-fee structures. Providers have no alternative buyer for in-network patients, allowing TPAs to impose non-negotiable rates that ignore inflation, scope of service, and patient need. Refuse, and you lose access entirely.

 

 

 
Responsible Parties:

1. Third-Party Administrators (TPAs) – American Specialty Health, Zelis

These companies exercise monopsony power — functioning as the dominant or sole “buyer” of acupuncture services within major insurance networks. Because they hold the exclusive contracts to manage benefits for insurers like Cigna, Anthem, and UnitedHealthcare, providers have no competitive alternative for in-network patient access. This allows TPAs to impose take-it-or-leave-it rates that have remained frozen for over a decade, regardless of inflation, service complexity, or time spent. Refusing their terms means losing access to those patients entirely — a structural imbalance that undermines fair market competition.

 

2. Insurance Companies – Cigna, Anthem, UnitedHealthcare, and others
Outsource acupuncture benefits to TPAs and maintain CAM classification to justify lower pay scales.

 

3. California Acupuncture Board (CAB)
Recognizes Licensed Acupuncturists as primary care providers but has not investigated or reported on the impact of stagnant rates and TPA control on the profession’s viability.

 

4. California Legislature & Department of Managed Health Care (DMHC)
Have the authority to regulate TPAs, mandate insurance parity, and reclassify acupuncture — but have failed to act.

 

Documented Impact:

1. New practitioners cannot afford to enter or remain in the profession.
2. Established providers are leaving networks or closing practices.
3. In-network provider availability is declining, reducing patient access.
4. Acupuncturists are reimbursed far less than other licensed health professionals for comparable services.

 

 
We Demand:

1. Insurance Parity – Reimburse Licensed Acupuncturists at rates comparable to other medical professionals for equivalent services.
   Regulation of TPAs – Limit the ability of companies like ASH and Zelis to impose fixed rates without provider input.
2. Reclassification of Acupuncture – Remove acupuncture from the CAM category and recognize it as mainstream medicine under California law and insurance regulation.
3. Board Action – Require the California Acupuncture Board to study and report on the impact of stagnant reimbursement and TPA control, and submit findings to the Legislature and DCA.
4. Legislative Oversight – Require the Legislature and DMHC to enact regulations ensuring competitive, sustainable reimbursement for Licensed Acupuncturists.

 

 

This is not a request for special treatment. It is a demand for fair, sustainable compensation for a profession held to the same licensing, education, and insurance requirements as other primary care providers in California. Without action, the profession will continue to shrink, and patient access to acupuncture will disappear.

 

 

 

 

 

Sign and share to support fair pay, professional sustainability, and the future of acupuncture in California.