Does Medicare cover acupuncture?

Acupuncture typically isn’t covered by Medicare, except for treatment for chronic lower back pain, which Medicare Part B covers.

If you’ve experienced low back pain for at least 12 weeks and the pain isn’t associated with another cause, such as cancer that has spread, inflammatory or infectious disease, surgery or pregnancy, you’re entitled to 12 acupuncture sessions within a 90-day period.

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Medicare may pay for up to eight additional sessions if your pain decreases as a result of acupuncture, but it sets a maximum at 20 sessions a year. If your chronic back pain doesn’t improve with acupuncture during the first 12 visits, Medicare won’t cover additional treatments.

Acupuncture is a type of traditional Chinese medicine that stimulates the central nervous system by inserting a series of needles into strategic areas of the body using gentle movements to alleviate pain. Until January 2020, Medicare didn’t cover acupuncture under any circumstances. The Centers for Medicare & Medicaid Services changed the rules in part to offer an alternative to opioids for lower back pain.

But this condition is the only exception. Medicare also won’t cover other forms of alternative medicine with the exception of chiropractic care for medically necessary spinal manipulation.

What providers qualify for acupuncture coverage?

To qualify for coverage, the acupuncture must be administered by a doctor or other health care provider, such as a nurse practitioner or physician assistant, who meet both of these criteria:

• A master’s or doctoral level degree in acupuncture or Oriental medicine from a school that has accreditation from the Accreditation Commission on Acupuncture and Oriental Medicine.

• A current, full, active and unrestricted license to practice acupuncture in the state or territory where you’re receiving care.

How much do I pay for Medicare-covered acupuncture?

After you’ve met your annual Medicare Part B deductible, which is $240 in 2024, you’ll pay 20 percent of the Medicare-approved amount for the eligible acupuncture sessions.

You can buy a private Medicare supplemental policy to help cover Medicare’s deductibles, copayments and coinsurance. All Medigap policies cover the 20 percent Part B coinsurance in part or full.

Keep in mind 

If you have a private Medicare Advantage plan, rather than original Medicare, you may have broader coverage for acupuncture. Some Medicare Advantage plans cover acupuncture for pain in other parts of the body in addition to the lower back.

Ask your plan about its coverage rules. You could have a copayment, maybe $20 a visit, and need to see a provider in your plan’s network.

You can also find plans in your area that provide acupuncture coverage in the Medicare Plan Finder.

• Within each result, click Plan Details and scroll down to the blue bar. Click + View more benefits & costs and scroll down to + View more extra benefits.

• You’ll see acupuncture in the list of Medically approved nonopioid pain management services. You can also find out about coverage for chiropractic services, massage therapy and alternative therapies in that section. Contact the plan or review the Summary of Benefits at its website for more details.

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