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ASH 2026 Updates for Acupuncturists: New Benefits, New Agreement, and Key Reminders

Updated: 2 days ago


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American Specialty Health Group (ASH Group) has issued its annual end-of-year notification for acupuncture and Oriental medicine practitioners, outlining important changes that will take effect on January 1, 2026.


If you’re contracted with ASH, these updates affect your provider agreement, operations manual, fee schedules, incentive programs, and how certain health plans cover acupuncture services.


Below is a clear breakdown of what’s changing and what you should review before the new year.

1. Updated Practitioner Resources on ASHLink


Several key documents that govern your relationship with ASH have been updated and will replace all prior versions as of January 1, 2026. All of them are available through ASHLink, ASH’s secure practitioner portal, under the Resources tab.


Practitioner Services Agreement (PSA)

  • An Amendment to the Practitioner Services Agreement has been issued, which replaces the entire existing National Acupuncture and Oriental Medicine Practitioner Services Agreement.

  • A Summary of Changes highlights which sections were updated so you don’t have to search line by line.

  • Attachment D – Client Summaries and Fee Schedules are updated and can be viewed on ASHLink under Client Summaries. These include covered codes and contracted rates by plan.

  • Attachment I – State-Specific Requirements is also available on ASHLink. The effective date shown there will tell you whether a state-specific change has been made.


No signature is required on your part; per the agreement, this amendment is considered accepted after notice.


Practitioner Operations Manual


  • The Practitioner Operations Manual has been updated and is available on ASHLink under Operations Manual.

  • Be sure to review the “Updates to This Practitioner Operations Manual” page to see exactly what changed (e.g., policies, procedures, workflows).

2. Health Plans Adding or Expanding Acupuncture

Benefits via ASH


Effective January 1, 2026, several health plans are either adding new acupuncture benefits or expanding existing ones administered through ASH Group or ASH Plans. This means more potential covered patients in specific states and counties.


Here’s a quick summary:


Alignment Healthcare

  • New acupuncture benefits through ASH Group

  • Applies to Medicare Advantage HMO members

  • Implemented in Nevada and North Carolina


Ambetter Health Solutions

  • New acupuncture benefit through ASH Group

  • Applies to HMO and EPO members

  • Implemented in:

    • Arizona (HMO)

    • Florida (HMO)

    • Kansas (EPO)

    • Nebraska (EPO)

    • Oklahoma (HMO)

    • Tennessee (EPO)

    • Texas (HMO)


Champion Health Plan

  • New acupuncture benefits through ASH

  • Applies to Medicare Advantage HMO

  • Implemented in California and Nevada


Elite Health Care

  • New acupuncture benefits through ASH Plans

  • Applies to Medicare Advantage HMO

  • Implemented in California counties:

    • Los Angeles

    • Riverside

    • San Bernardino


Molina Healthcare

  • New acupuncture benefits through ASH Group

  • Applies to Medicare Advantage HMO

  • Implemented in Iowa


Providence Health Plan

  • Additional acupuncture benefits through ASH Group

  • Applies to Commercial Network Access and Medicare Advantage HMO & POS

  • Implemented in Oregon and Washington


San Francisco Health Plan

  • New acupuncture benefits through ASH Plans

  • Applies to Medicare Advantage HMO

  • Implemented in California counties:

    • San Francisco

    • Alameda

    • Contra Costa

    • Marin

    • San Mateo

    • Santa Clara

    • Solano


Verda Health Plan of Arizona

  • New acupuncture benefits through ASH Group

  • Applies to Medicare Advantage HMO

  • Implemented in Maricopa County, Arizona


Wellcare

  • New acupuncture benefits through ASH Group

  • Applies to Medicare Advantage HMO and POS

  • Implemented in Oregon and Texas


For each of these plans, you should review the Client Summary and Fee Schedules on ASHLink to understand coverage, authorization requirements, and reimbursement.


3. Coverage Discontinuation: eternalHealth

One plan is ending its relationship with ASH:


  • eternalHealth is discontinuing use of ASH Group for acupuncture benefits effective September 30, 2025.

  • For dates of service on or after October 1, 2025, acupuncture claims should be sent directly to eternalHealth, not ASH.

  • This termination affects Arizona and Massachusetts.


If you see eternalHealth members in these states, update your billing workflows accordingly.



4. 2026 Administrative Updates & Reminders


Review Fee Schedules

ASH reminds practitioners to review health plan fee schedules for 2026.


  • Covered code sets may change due to code replacements (e.g., CPT/ICD/HCPCS updates).

  • Rates may also be adjusted.Checking these early helps avoid underpayments and denials.


Incentive Payment Program Ending (Attachment J)

The Incentive Payment Program (Attachment J) – which rewarded use of electronic tools – is being discontinued.


Key points:

  • ASH will no longer pay incentive payments tied to electronic engagement after December 2025.

  • The final incentive payment will be made in January 2026 for services rendered in December 2025.

  • ASH will no longer assess administrative processing fees for not using electronic tools (that fee was previously tied to Attachment J).

  • The paper check administrative processing fee (for not using direct deposit) will remain.


Even though incentives are ending, ASH continues to promote ASHLink as the standard way to manage authorizations, claims, and resources.


ChooseHealthy® Program Reminders

As an ASH contracted practitioner, you’re also part of the ChooseHealthy® Program, a national discount program:

  • Members can self-refer to your office with a ChooseHealthy Discount Certificate (printed or electronic).

  • Certificates are available to members through the Find a Provider search on ChooseHealthy.com.

  • No eligibility verification is required; any member presenting a valid certificate is eligible for the discount.


Review your Practitioner Services Agreement and ChooseHealthy Program Client Summary for details on fees and discount expectations.


Clinical Performance System (CPS) Cycle Reset


For practitioners on a January–December CPS cycle:


  • The CPS cycle resets January 1, 2026.

  • If a course of care approved in 2025 extends into 2026, the new 2026 CPS visits start only after the existing approved visits are exhausted (either all visits used or the end date passed).

  • CPS visits are per patient per calendar year, not per condition.

For members with a health plan waiver:

  • The waiver also resets January 1, but there is no transition—you can treat with no MNR (medical necessity review) for the number of services shown on ASHLink.

  • If you choose to continue using an existing 2025 authorization into January, you give up the waiver for 2026 for that patient.


If your CPS cycle is not January–December, this reset does not apply. You can confirm your CPS cycle in ASHLink under the patient’s Clinical Performance System (CPS) section.


ICD-10 Code Lists Moving

Starting January 1, 2026, ICD-10 code lists will move within ASHLink:

  • They’ll be found under Resources > Practitioner Education Library > Administrative Topics, organized by specialty.


Direct Deposit Encouraged

ASH continues to promote Direct Deposit for faster payments and to avoid paper check fees:

  • Direct Deposit reduces payment delays and risk of identity theft.

  • You can enroll using the Direct Deposit Authorization Form under the Forms section on ASHLink.


Use ASHLink for Efficiency

ASH is strongly encouraging practitioners to rely on ASHLink for:

  • Eligibility and benefit verification

  • Claims submission

  • Access to updated policies, manuals, and forms

  • Client summaries and fee schedules


If you don’t already have an account, you can create one at ASHLink.com using your Tax ID and the email address associated with your ASH agreement.



5. Summary of Key Agreement Changes


The notice also includes a Summary of Changes to the National Acupuncture and Oriental Medicine Practitioner Services Agreement, effective January 1, 2026:


  • Article 2 – ASH Group’s Responsibilities

    • A new section on claims payment, direct deposit, and administrative processing fees (3.19) has been added, incorporating language that used to be in Attachment J.

  • Article 4 – Contracted Provider’s Responsibilities

    • 4.02 Coordination of Care now specifically includes clinic-based physical, occupational, and speech therapists as part of coordinated care.

    • 4.11 Appeal Rights has been clarified to explicitly cover claims and non-claims disputes, and to reference appeal rights described in the Operations Manual.

    • 4.11(e) Appeal of Clinical Performance System (CPS) Tier Designation has been added, giving practitioners defined rights to appeal CPS tier assignments.

  • Attachment J – Incentive Payment Program

    • Removed entirely, along with all references to it.

  • Additional formatting and minor clarifications have been made throughout the agreement.


Final Thoughts


These annual updates from ASH Group are more than just administrative housekeeping—they directly affect how you get paid, how you coordinate care, and which patients you can serve under specific plans and products.


Before January 1, 2026, it’s a good idea to:


  • Log in to ASHLink

  • Review your updated Practitioner Services Agreement and Operations Manual

  • Check Client Summaries and fee schedules for your top plans

  • Confirm your CPS reset date and understand how it affects authorizations

  • Consider enrolling in Direct Deposit if you haven’t already


Staying ahead of these changes will help keep your practice’s operations smooth and your revenue steady going into 2026.

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