Does Medicare Pay for Acupuncture?

Christian Worstell
In this article...
  • Medicare covers acupuncture treatments under certain circumstances. Learn how Medicare pays for acupuncture and what to ask your doctor.
A doctor performing acupuncture treatment

Historically, Original Medicare (Medicare Part A and Part B) did not offer any coverage for acupuncture, but that changed in January of 2020. 

On January 21, 2020, the Centers for Medicare & Medicaid Services (CMS) finalized the decision that Medicare will cover acupuncture for patients with chronic lower back pain.

The decision was based partly on recent studies showing positive results for patients receiving acupuncture treatment, and it’s part of a continued effort to expand Medicare coverage of non-opioid pain management.

When Will Medicare Cover Acupuncture?

Acupuncture is covered by Medicare Part B. In order for the acupuncture to be covered, the patient must be experiencing chronic back pain.

Chronic back pain is defined as:

  • Pain that has persisted for 12 weeks or longer
  • Pain that is not related to cancer, infectious disease, inflammation, pregnancy or surgery

If a beneficiary’s lower back pain meets the above guidelines to be classified as chronic pain, Medicare Part B will cover up to 12 session of acupuncture treatment in 90 days. Medicare will then cover an additional eight sessions if the beneficiary shows signs of improvement, for a total of 20 covered sessions. No more than 20 treatments will be covered in the same calendar year. 

Will My Doctor Accept Medicare for Acupuncture?

Medicare will only cover acupuncture when it’s performed by a doctor or other health care provider who possesses the following credentials:

  • A master’s degree or doctorate degree in acupuncture or traditional Asian medicine from a school that is accredited by the Accreditation Commission on Acupuncture and Oriental Medicine

  • An active and unrestricted license to practice acupuncture in the state where the service is being provided 

Original Medicare does not cover acupuncture for any other condition besides lower back pain.

How Much Does Acupuncture Cost With Medicare?

The official government website for Medicare has not yet released any cost details for Medicare acupuncture coverage.

Most health care services covered by Medicare Part B are subject to the annual Part B deductible ($226 in 2023) and typically a 20% coinsurance payment for all remaining charges after the deductible has been satisfied.

Do Private Medicare Plans Cover Acupuncture?

While the 2020 ruling allows Original Medicare to cover acupuncture, some Medicare Advantage (Medicare Part C) plans were already covering it.

By law, Medicare Advantage plans must provide at least the same basic benefits as Original Medicare. So any Medicare Advantage plan that did not previously cover acupuncture must now do so in order to align with the acupuncture coverage offered by Part B. 

Medicare Advantage plans may also offer expanded coverage or additional benefits for other services not covered by Original Medicare. So there may be some Medicare Advantage plans that offer acupuncture coverage beyond just the chronic lower back pain coverage that is now found under Part B.

Most Medicare Advantage plans also offer prescription drug coverage, which may include prescriptions to help with chronic pain. Original Medicare doesn’t typically cover prescription drugs.

About Acupuncture

Acupuncture is a form of alternative medicine and one of the key components of traditional Chinese medicine. Acupuncture can stimulate specific points on the body by inserting thin needles through the skin. It is most often performed to treat pain, but is also used for migraines, nausea and vomiting caused by chemotherapy, cramps and more. 

Alternative medicine is typically not covered by Medicare, so the decision to offer Medicare acupuncture coverage was not insignificant.

Thousands of Americans die every year as a result of opioid addiction, and the addition of acupuncture to the list of covered Medicare benefits is a signal that Medicare is making good on its commitment to expand coverage of pain relief therapies that don’t involve opioids. 

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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