Does Medicare Cover Acupuncture?
Key Takeaways
Acupuncture is covered by Medicare in one specific scenario: when it is used for the treatment of chronic low back pain.
Acupuncture procedures involve the pricking of the skin with a series of small needles to treat a number of physical and mental concerns.
Part B of Original Medicare will cover 12 acupuncture treatments in 90 days for chronic low back pain and will then cover eight more sessions if you are improving.
Is Acupuncture Covered by Medicare?
In 2020, Medicare began covering acupuncture for the treatment of chronic low back pain. Medicare acupuncture is limited to that specific situation, and there are rules regarding who can administer the treatment in order for it to be covered.
Does Medicare ever pay for acupuncture?
In order to pay, Medicare requires acupuncture to be administered by a “doctor, or by another health care provider (like a nurse practitioner or physician assistant) who has both of these:
- A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine
- A current, full, active, and unrestricted license to practice acupuncture in the state where care is being provided”
How much does Medicare pay for Acupuncture?
Part B of Original Medicare will cover 12 acupuncture treatments in 90 days for chronic low back pain and will then cover eight more sessions if you are improving. If your doctor doesn’t think you are improving, Medicare won’t cover more treatments.
Twenty treatments is the maximum that will be covered in one year.
Medicare Advantage will cover the same and, in some cases, more treatments or acupuncture-related services. Medicare Advantage (Part C) replaces Original Medicare (Parts A and B) but offers the same Parts A and B coverage as Original Medicare. Along with including Part A and B benefits, Medicare Part C often bundles additional services.
How does Medicare Bill for Acupuncture?
As is standard with Part B, Medicare will pay 80 percent of an acupuncture treatment after you pay your annual deductible. You will be expected to pay the other 20 percent in coinsurance.
If you have switched to Medicare Advantage, your treatment will be covered under the same rules, but costs may be different than with Original Medicare.
Does Medicaid cover acupuncture?
If you are on Medicare and Medicaid, then Medicaid covers the same things that Medicare does, including acupuncture for chronic low back pain. You won’t pay any more than what you have to pay on Medicare and likely will pay less.
