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.

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.