About Complementary and Alternative Medicines
Complementary and Alternative Medicines (CAM) include a variety of non-medical treatment modalities that fall outside the general definition of traditional medicine. CAM treatments include, but are not limited to:
- Chinese medicine
- Chiropractic treatment
- Holistic medicine
- Massage therapy
- Music therapy
- Naturopathic medicine
- Other natural healing methods
CalVCB allows a combined five (5) CAM sessions per direct victim application. Once the five sessions have been reached, an additional 15 sessions (not to exceed a total of 20 sessions) may be approved with written documentation from a licensed medical or mental health provider. The recommendation must be submitted using one of the following formats:
- The Complementary and Alternative Medicines Verification Form
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- A written recommendation on the provider’s business letterhead or prescription pad which includes the provider’s name, telephone number, business address, signature, date, license number and expiration date, number of CAM sessions recommended beyond the first five (5) sessions, not to exceed a maximum of 20 total sessions and a justification for the additional CAM sessions.
Reimbursement for CAM treatment is based upon the type of provider and type of treatment. CAM providers will be reimbursed at Medicare rates when applicable.
When mental health providers utilize Biofeedback, Hypnotherapy, and Music therapy they will be reimbursed at CalVCB mental health provider rates, based on licensure. In these cases, sessions are counted towards mental health benefit limits and claimants may be eligible for up to 40 sessions. The sessions are not counted towards the CAM limits. No authorization letter is required when a licensed mental health provider utilizes one of these treatment methods. Mental health bills must be submitted on the CMS1500 with the appropriate CPT code.
Submit the completed Complementary and Alternative Medicines Verification Form or recommendation letter to:
PO Box 3036
Sacramento, CA 94204-2003
Please note that submission of a request for additional CAM sessions does not automatically authorize those sessions. The claimant may be held financially liable for any CAM sessions not approved beyond the first five (5).
If you have any questions, please call our Customer Service line at 1-800-777-9229.