Acupuncture Now Included in Medicare Coverage

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare coverage will now include acupuncture for chronic low back pain. With opioid use becoming more widespread, an increasing number of studies support the effectiveness of alternative treatments as compared to prescription pain medications. 

In traditional Chinese medicine, acupuncture is thought to balance the “qi,” or “life force” throughout the body. Inserting needles at critical points, called meridians, is thought to improve this flow. For Western practitioners, many believe that acupuncture boosts the body’s natural painkillers by stimulating nerves, muscles, and tissues. 

And, as an added bonus, the side effects of acupuncture–in the rare case they occur–are much milder and short-term than the side effects of prescription painkillers. 

What is Covered? 

If you have had chronic lower back pain for a minimum of 12 weeks, the new Medicare coverage includes up to 12 acupuncture treatment sessions within 90 days. After that, patients are allowed eight additional sessions if their pain decreases; that’s a total of 20 sessions per year. For specific details on patient costs, you’ll need to consult your plan administrator. 

To qualify for coverage, the acupuncture sessions must be performed by a healthcare provider who has both a master’s or doctoral-level degree in acupuncture from an accredited school, and a current license to practice acupuncture in the state where care is being provided. 

What is Not Covered? 

Acupuncture treatments are not covered for back pain that is related to recent surgery, pregnancy, or illness. Only chronic back pain with no identifiable systemic cause (i.e., not associated with metastatic, inflammatory, infectious, etc. disease) will be covered. Dry needling and acupuncture injection therapy are also not covered by Medicare. 

For more information on your specific coverage details and patient costs, always consult with your plan administrator. Your health care provider can discuss your specific treatment plan and prognosis. 

At Pain Arthritis Relief Center, we’re here to help you feel better and get well. To find out if you’re eligible, schedule your pain relief consultation with us: