NYSHIP & HSA/FSA & No Fault Accepted
HSA/FSA Client Checklist
Before Your Appointment
1. Get a Prescription/LMN: Visit your doctor or chiropractor to get a Letter of Medical Necessity (LMN).
2. Verify the Code: Ensure the doctor includes a specific ICD-10 diagnosis code (e.g., M54.5 for back pain).
3. Check Expiration: Make sure your LMN is dated within the last 12 months.
At Your Appointment:
1. Bring your LMN: Give a copy to your therapist for your clinical file.
2. Payment: Use your HSA/FSA debit card. Note: If the card is declined due to merchant category settings, pay out-of-pocket and request an itemized receipt for reimbursement.
3. Gratuity: Tips cannot be paid with HSA funds. Please bring cash or a personal card if you wish to tip.
After Your Appointment:
1. Keep Your Receipt: Your therapist will provide an itemized "Superbill" with CPT codes and license info.
2. File for Reimbursement: If you didn't use an HSA card, submit the LMN and the itemized receipt to your HSA provider.