Is acupuncture covered by Medicare?

As of January 2020, Medicare covers acupuncture treatment for chronic low back pain, according to the Centers for Medicare & Medicaid Services.1 The coverage is subject to limitations on the number of sessions and the type of provider administering the treatment.2

Here’s a deeper look into acupuncture and Medicare.

What is acupuncture?

Acupuncture is a pain-relief technique that stimulates specific points on the body. There are many types of acupuncture, and one of the most common is the traditional Chinese method, which inserts thin needles into the body. Conditions typically treated include back pain, neck pain, knee pain and headaches.3

Does Medicare only cover acupuncture for chronic lower back pain?

Yes. Characteristics that define chronic low back pain include:

  • Pain lasting 12 weeks or longer
  • Pain that’s not associated with surgery or pregnancy
  • No identifiable systemic cause (not associated with metastatic, inflammatory or infectious disease)4

What parts of Medicare pay for acupuncture?

Acupuncture for chronic lower back pain is covered under Part B, if a beneficiary has Original Medicare.

Acupuncture for chronic lower-back pain is covered under Medicare Part B for up to 12 visits in 90 days. If your chronic lower-back pain improves, your plan may cover another 8 visits. If your doctor determines your condition is not improving or is getting worse, acupuncture treatments will no longer be covered. There is a limit of 20 acupuncture treatments per year.5

Where can I get acupuncture treatments paid for by Medicare?

Medicare will only cover acupuncture treatments administered by a doctor or healthcare provider with the following credentials:

  • A master’s degree or doctorate in acupuncture or Oriental medicine, from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine
    and
  • An active and unrestricted license to practice acupuncture in the state where care is being provided6

Get the relief you need

Medicare now covers acupuncture as treatment for chronic low back pain. If you believe you’re eligible and need treatment, contact your healthcare provider for more information.

Sources:

  1. “Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N),” Centers for Medicare & Medicaid Services, last accessed October 2, 2020, https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=295, opens new window.
  2. “Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N).”
  3. “Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N).”
  4. “Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N).”
  5. “Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N).”
  6. “Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N).”

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