Policy Updates to Chiropractic, Massage Therapy and Acupuncture Care

We recently conducted a thorough review of our community referral process for acupuncture, medical massage therapy, and chiropractic care to ensure that we're adhering to the clinical guidelines outlined by the MISSION Act. During this review, we found some inconsistencies where the care provided did not fully meet the established clinical criteria.

We want to inform you we have taken steps to correct these inconsistencies and ensure our practices are aligned with the national guidelines, so you continue to receive the clinically appropriate care you deserve.

These national guidelines outline the number of approved visits and duration of care for each of these healthcare modalities, such as 90 days/12 visits for initial chiropractic care, 60 days/12 visits for initial acupuncture, and 90 days/12 visits for initial massage therapy. Depending on the severity of the condition being treated and the effectiveness of the care being provided, additional visits over an extended period of time may be prescribed. Any care provided beyond the scope of the national guidelines without the necessary documentation will not be authorized. 

For more specifics about the nationally established guidelines we are following, please see the below breakdown for the Standard Episodes of Care (SEOC) for acupuncture, medical massage therapy, and chiropractic care. 

If you have any questions about how these changes impact your care, please contact your Primary Care team. To schedule an appointment with your team, please call 928-445-4860 and press 2. 

We appreciate your understanding and cooperation as we work to enhance our services for you. Thank you for allowing us to be a part of your healthcare journey and for your continued support.

Initial SEOC 

Trial of care for services that have not been used (i.e., new injury)

Chiropractic – 12 visits, 90-day

Acupuncture – 12 visits, 60-days  

Massage Therapy – 12 visits, 90-days  

If that trial was unsuccessful, no further care would be indicated or authorized

If that trial was successful, but no further improvement anticipated, no further care would be indicated or authorized

If that trial was successful and there was felt to be further benefit/improvement, Continuation SEOC would be indicated and authorized 

Continuation SEOC

Additional lasting improvement is expected. This includes the rare cases that have not resolved or plateaued within the initial 12 visit trial. 

Chiropractic – 6 visits, 60-days

Acupuncture – 8 visits, 90-days 

Massage Therapy – 12 visits, 180-days 

If continuation of initial care was unsuccessful OR no further improvement is expected, no additional care would be indicated or authorized

If no further improvement is expected but patient experiences loss in function upon care discontinuation, Pain Management SEOC could be indicated and authorized (there is NO Pain Management SEOC for massage therapy, chronic (beyond 180 days) enduring care is not indicated or authorized)

Pain Management SEOC 

Requires patient compliance with active care & self-management strategies be utilized (i.e., home exercise, stretching, yoga, Tai Chi, wt. loss) along with medical, behavioral, social interventions.

Chiropractic – 8 visits, 180-days

Acupuncture – 8 visits, 180-days

Massage Therapy – No pain management SEOC, care limited to initial and continuation SEOCs  

What About Other Resources?

Pain Team Programs

The following programs are available through either self or Primary Care Physician referral:

• AMP (Active Management of Pain) (in person or VVC) - An 8-week group that teaches fundamental, self-management skills to help Veterans better manage the aspects of chronic pain that they can control. AMP helps Veterans move toward doing more of the things that are meaningful to them and improve their quality of life.
• Living Well (VVC) - An 8-week group that focuses on creating a positive context to change how the brain is responding to signals from the nervous system. Veterans will create a Thriving Plan using techniques and tools taught in the class.
• Pain Reprocessing Group (VVC) - A 6-week group that teaches ways to understand chronic (neuroplastic) pain in a different way and change how our brain and nervous system respond to reduce pain and engage in life.
• Why I Hurt Group (VVC) - A 4-week group that provides a roadmap to help reduce the brain’s perception of threat to help get back to valued activities.
• Reset(VVC) - This guided meditation group combines educational information about mindfulness and the principles and practice of Integrative Restoration (iRest®) and Mindfulness-Based Stress Reduction (MBSR).
• B.A.S.I.C. Training (VVC) – A 6-week group focuses on the science of the brain-body connection, ANS processes and the history of the vagus nerve, the polyvagal theory hierarchal model and the purpose of state regulation with skill implementation to reset the nervous system for more fluid and resilient response patterns.
• At Ease: Rest & Regulate (VVC) – A 3-week group that focuses on breath science and philosophy, breath functions, and breath practices to address dysfunctional breathing patterns that influence medical and mental health problems
• Pain management providers

Whole Health Offerings

Whole Health puts you at the center of care, rather than your illnesses or conditions. We work with you to develop a personalized health plan based on your values, needs, and goals.

Here is a complete list of our current Whole Health offerings:

Mindfulness Class.  Offered in-person and online on Thursdays at 2-3pm.  Registration is required, call 928-445-4860 EXT. 4843

Mindfulness means purposely paying attention to the present moment.  Mindfulness has been shown to be effective for reducing stress, improving resilience, increasing self-awareness, helping anxiety and depression, and coping more effectively with chronic pain.

Diabetes Education Classes.  Offered in-person and online.  Registration is required.  Call 928-445-4860 EXT. 2581 for more information on days and times of classes.

Prediabetes class:  For Veterans with confirmed diagnosis of prediabetes-Learn how to defeat prediabetes and avoid getting diabetes!  Get your questions answered by a Registered Dietician and a Diabetes Nurse Educator.

Diabetes Class:  For Veterans with confirmed diagnosis of diabetes-Learn how to take charge of your diabetes and avoid complications!

Health and Wellness Coaching.  Registration is required. 928-445-4860 EXT. 6966

Whole Health Coaching optimizes well-being by assisting people to achieve health goals based on what is important to them.  Coaching is Veteran centered and explores mindfulness, what matters most, self-care strategies and making behavior changes based on values. 

Healthy Teaching Kitchen. Registration is required. 928-445-4860 EXT. 6386 Online and In-person.

Making healthy food choices is the #1 thing you can do for your health.  Learning how to cook can be one step towards getting healthier foods on your plate.  The Healthy Teaching Kitchen provides cooking classes for Veterans to increase nutrition knowledge, cooking skills, and build confidence in cooking at home with healthy, minimally processed foods.

MOVE! Program. Registration is required.  928-445-4860 EXT. 6821. In-person and online.

A 16-week Multidisciplinary Approach to Weight Management for our Veterans with a focus on improving health through Nutrition and Lifestyle changes.  Support and Education for Eating Wisely and Increasing Physical Activity.  Coaching and Feedback to Help Reach Weight Management Goals.  For any questions regarding this program please call Deborah Drumel, Registered Dietician, at the number above.

Smoking Cessation Group. Registration required. Please contact your Medical Provider or team for a consultation. This class is offered online and in-person.

This four-week class focuses on supporting the Veteran in quitting nicotine smoking. 

Occupation Therapy Groups. Registration is required 928-445-4860 EXT 6243

Learn how to implement strategies to assist with identifying and challenging maladaptive thought patterns, improving emotional regulation, cultivating joy, and building resilience.  Utilizing a foundation of lifestyle redesign developed at USC combined with positive psychology and CBT a core aim of this group is to help people lead fulfilling lives and cultivate what is best within them, to move beyond surviving to thriving.  Please call if you have any questions regarding this group. 

Occupation Therapy Groups. Registration is required 928-445-4860 EXT. 6243

This group provides a space for social experience amongst a group of veterans, facilitated by a therapist. The focus is on engagement in meaningful occupation or simply doing something that matters to you (making a leather wallet, weaving a rug, panting a memory, etc.). 

Flow Group. Registration is required 928-445-4860 EXT. 6243 Please call for more information.

Offering a time free from distraction, a moment of peace during chaos.  This time allows for facilitation in the realms of mindfulness, flow and meditation.  The aim of this group is to experience the present, to experience flow-state, and to assist in quieting the nervous system.  This time can be generalized and applied by establishing a foundation for daily routine of self-care, improving overall quality of life, and increasing mental wellness.

Ompractice. This is a free online fitness and mindfulness platform for Veterans that offers unlimited access to over 100 weekly classes of yoga, tai-chi, meditation and more. Learn how to join by clicking HERE.