Does Medicare cover acupuncture?

Published by Medicare Made Clear®

Does Medicare cover acupuncture?

Acupuncture involves the insertion of thin needles into your skin at strategic points on your body. This treatment is commonly used to help with managing pain and can offer other health benefits over time.

The use of acupuncture is growing in popularity and is a component of traditional Medicine that is widely practiced and researched by leading medical experts and facilities, including Mayo Clinic, to relieve pain and discomfort associated with a variety of conditions. So, with acupuncture being considered a popular preventative health and conventional treatment option, it begs the question “Will Medicare cover acupuncture treatment?”

When does Medicare cover acupuncture?

It depends on what the acupuncture is treating. In general, Medicare doesn’t cover acupuncture treatment (including dry needling). Some Medicare Advantage plans may provide acupuncture coverage. You’ll need to check with the plan provider to find out what is or isn’t covered.

Medicare will cover acupuncture if it’s specifically for treating chronic low back pain. This is pain in the lower back that continues for more than three months.

If you are seeking acupuncture treatments for a reason other than chronic low back pain, you may want to consider enrolling in a Medicare Advantage (Part C) plan.

Medicare Part B will cover acupuncture for chronic low back pain

In 2020, the Centers for Medicare & Medicaid Services (CMS) officially declared that Medicare would cover acupuncture for patients with chronic low back pain. This decision was made as part of an effort to support alternative, non-opioid pain therapies as well as aid in reducing the risk for opioid dependency.

Medicare Part B covers acupuncture for chronic low back pain when you get treatment from a licensed acupuncturist with either a master’s or doctoral-level degree in acupuncture or “Oriental Medicine” from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine. Your plan may cover up to 12 acupuncture treatments within a 90-day period. If the doctor that referred you believes that your chronic back pain is improving due to the acupuncture treatments, your Medicare plan may cover up to eight additional treatments. In total, Medicare Part B may cover a maximum of 20 acupuncture treatments per calendar year.

How much does acupuncture cost with Medicare?

To find out how much your treatments will cost, you should talk to your health care provider and Medicare plan provider before scheduling your services. Your total costs may vary based on things like how much your health care provider charges, other insurance you may have, or whether your health care provider accepts assignment.

NOTE: Acupuncture coverage for cLBP was added to Medicare Part B plans as of January 21, 2020, and treatments completed prior to that date may not be covered.

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