WA L&I Acupuncture Pilot Project

DLI has implemented an Acupuncture Pilot Project. It’s only for workers with low back injuries at this time.

The Acupuncture Pilot Project will collect information to inform the provision of acupuncture treatment for low back pain, including acupuncture provided by East Asian Medicine Practitioners (EAMPs), to injured or ill workers covered by Washington’s workers’ compensation system.

This project provides a structured environment for care delivery and capture of data that will inform future L&I payment and coverage methodology for acupuncture.

While the project is underway, the Department of Labor & Industries (L&I) will pay qualified providers participating in the pilot project to deliver acupuncture treatment to injured workers with low back pain related to an accepted condition on a workers’ compensation claim.

Treatment Must Focus on Functional Recovery and Return to Work

Under workers’ compensation insurance, acupuncture treatment must focus on helping occupationally injured and ill workers heal and return to work.

Treatment covered in the pilot project

  • Low back pain related to an accepted condition on a workers’ compensation claim.
  • When ordered by the workers’ attending provider, up to 10 treatments over the lifetime of the claim.
  • When documentation shows clinically meaningful improvement in pain and function.

Treatment NOT covered in the pilot project

  • Treatment beyond the medically necessary number of visits, not to exceed the 10 visit maximum.
  • Injured worker has reached maximum medical improvement.
  • Treatment that does not improve physical function of the industrial injury or occupational disease.
  • Any other modality not specifically listed.

Use of Oswestry Disability Index and 2-item Graded Chronic Pain Scale is required

The insurer uses the patients’ functional scores to assess the improvement in pain and function. Under the terms of the Acupuncture Pilot Project, must be completed and sent to the department as required under authorization and reporting.

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