Medicare does cover some acupuncture treatments. But, Acupuncture is only covered if it treats chronic lower back pain. Medicare won’t pay for other types of acupuncture treatments. But, some Advantage plans offer extra benefits beyond Medicare. Below you’ll learn which services qualify for coverage and when you’ll pay the bill.
Is Acupuncture Covered by Medicare?
Historically, Medicare doesn’t cover acupuncture. The Centers for Medicare and Medicaid Services announced they would include acupuncture for chronic lower back pain. The decision is part of an effort to support alternative pain therapies and reduce dependence on opioid painkillers.
CMS says there were a small number of studies on acupuncture for lower back pain in people over 65. But the patients saw improvement in both pain and function. Medicare covers acupuncture for the pain that affects your lower back and is considered chronic.
Chronic lower back pain must meet these criteria:
- The pain has lasted at least 12 weeks
- Pain doesn’t have an identifiable cause such as cancer or a disease
- Isn’t related to surgery or pregnancy
What Acupuncture Treatments are Not Covered by Medicare?
The new Medicare rule applies to acupuncture for chronic lower back pain. There’s no Medicare coverage for acupuncture to treat neck pain, headaches, stress, or relief from chemo. Medicare does NOT cover acupuncture to treat pain in other parts of the body. Also, Medicare doesn’t pay for acupuncture to treat temporary acute pain, such as pain from a recent injury. Further, it won’t cover pregnancy-related lower back pain.
Why Doesn’t Medicare Cover Acupuncture?
Mostly, Medicare doesn’t cover acupuncture (outside of relief for chronic lower back pain) because this treatment is still considered naturopathic care. For those with chronic pain in other places, you’ll likely need to see a pain management specialist. In instances where the pain is caused by a misaligned spine, chiropractic care may have coverage.
How Long Will Medicare Cover Acupuncture?
Medicare will pay for up to 12 acupuncture visits in 90 days. It will also cover an additional eight months for patients who have shown improvement. Medicare covers at most 20 sessions per year.
Which Medicare Advantage Plans Offer Acupuncture?
Medicare Advantage plans vary by location, not all plans offered are going to cover Acupuncture. But, Humana and UnitedHealthcare both offer plans in select areas with some acupuncture coverage. There may be other carriers that offer this benefit, but it really just depends on the plans available in your service area.
What Medicare Supplement Plan Covers Acupuncture?
Medicare Supplements will cover any benefit that Medicare covers. So, if Medicare approves the acupuncture, the Medigap company will pay a portion of the bill. But, when Medicare denies coverage for treatment, Medigap won’t cover either.
How to Get Medicare Coverage for Acupuncture
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