Does Medicare Pay for Acupuncture?

8 Feb, 2022

Does Medicare Pay for Acupuncture?

The short answer is a qualified yes, under two conditions:

  1. Medicare will only pay for acupuncture if it is performed by a medical doctor (MD) or a nurse practitioner or physician’s assistant that also has a master’s degree or higher in acupuncture or oriental medicine.
  2. The acupuncture treatment must be for chronic low back pain. Medicare defines chronic as more than 12 weeks.

If both of the above conditions are met, Medicare will pay for 12 visits occurring within 90 days. If acupuncture care is providing improvement, an additional 8 visits will be authorized. No more than 20 visits will be paid for in a calendar year.

CMS (Centers for Medicare and Medicaid Services) does not recognize acupuncturists as providers for Medicare, therefore acupuncturists may not bill Medicare for acupuncture.

In July 2021, bill H.R. 4803 known as “Acupuncture for Our Seniors Act 2021” was introduced in the House to include acupuncturists as providers for CMS. This bill has not progressed any further than introduction.

References

  1. Acupuncture.
  2. Does Medicaid Cover Acupuncture.”
  3. H.R.4803 – Acupuncture for Our Seniors 2021.”

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