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Home > Client FAQ > Does Medicare cover acupuncture?
Does Medicare cover acupuncture?
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Yes, but it's only covered for a limited set of provider types, notably excluding LAcs.

 

Medicare's recent changes includes allowing acupuncture for chronic low back pain, but only if it is performed by an M.D. or nurse with appropriate certification if performed in an M.D.'s office or under the supervision of an M.D.

 

Per Medicare Website

Acupuncture

 

Medicare Part B (Medical Insurance)

 covers up to 12 acupuncture treatments in 90 days for chronic low back pain.

Medicare covers an additional 8 sessions if you show improvement. If you aren't showing improvement, Medicare won't cover your additional treatments and you’ll pay 100% of the costs if you continue getting them. You can get a maximum of 20 acupuncture treatments in a 12-month period.

Note

Not all providers can give acupuncture, and Medicare can't directly pay Licensed Acupuncturists for their services. Medicare also doesn't cover acupuncture (including dry needling) for any condition other than chronic low back pain.

Your costs in Original Medicare

After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

What it is

Acupuncture is a technique where providers stimulate specific points on the body, most often by inserting thin needles through the skin.

Things to know

Chronic low back pain is defined as:

  • Lasts 12 weeks or longer
  • Has no known cause (for example, it's not related to cancer that has spread, or an infectious or inflammatory disease)
  • Isn't associated with surgery or pregnancy

You must get acupuncture from a doctor, or 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 you're getting care

 

Takeaway: Acupuncture by independent LAcs. is still not covered by Medicare.

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