Does Medicare cover acupuncture?

The common use for acupuncture is to treat pain. Increasingly, it’s used for overall wellness and stress management.

What is acupuncture? 

Acupuncture involves the insertion of very thin needles through the skin at strategic points on the body. Western practitioners view the acupuncture points as places to stimulate nerves, muscles, and connective tissues. Some believe this stimulation boosts the body’s natural painkillers. People say that the needles are not painful when correctly placed.

Does Medicare pay for acupuncture?

Yes, Medicare Part B does pay for acupuncture (including dry needling) but only for chronic low back pain. Medicare Advantage (Part C) plans may provide more extensive acupuncture coverage. But it depends on the plan. If a person does not have acupuncture covered by a Medicare Advantage (Part C) plan, they pay out of pocket for treatment. 

When did Medicare start covering acupuncture? 

Acupuncture covered by Medicare is a recent addition to Medicare benefits. Medicare began covering acupuncture for chronic low back pain in January 2020. This change is partly because of concerns about the health effects of dependency on opioid pain medication. It is also an integral part of traditional Chinese medicine, and practitioners have used it to treat conditions for thousands of years. 

Does Medicare cover a set number of acupuncture sessions? 

Medicare covers up to 12 acupuncture treatments in 90 days for chronic low back pain. Medicare covers an additional 8 sessions if the member shows improvement. They can get a maximum of 20 acupuncture treatments in a 12-month period.

If the individual isn’t showing improvement, Medicare won’t cover the additional treatments. And if the member continues to receive treatment, they pay 100% of the costs.

Does Medicare cover acupuncture for neuropathy?

Currently Medicare does not cover acupuncture for neuropathy. Patients who want to get acupuncture to treat pain from damaged nerves in their hands and feet must pay out-of-pocket for it. 

Does Medicare cover acupuncture for pain?

Medicare covers acupuncture for chronic low back pain only. To qualify, back pain must meet these specific requirements. 

• No known cause (lower back pain isn’t related to cancer that has spread, or an infectious or inflammatory disease).
• Lasting 12 weeks or longer.
• Not associated with pregnancy or surgery. 

Does Medicare cover acupuncture for knee pain? 

Although people report feeling pain relief in their knees after acupuncture, Medicare does not cover it.

Does Medicare cover acupuncture for neck pain? 

Neck pain can result from sudden stress or injury. It can also be chronic and long-lasting. Medicare does not cover any type of neck pain.

Does Medicare cover acupuncture for osteoarthritis? 

Osteoarthritis is a degenerative disease that affects the joints. It can also affect the spine. The  Centers for Medicare & Medicaid Services concluded in 2004 that acupuncture is not an effective treatment for osteoarthritis. As a result, Medicare does not cover acupuncture for osteoarthritis treatment unless it results in chronic low back pain. 

Does Medicare Advantage (MA) cover acupuncture? 

All Medicare Advantage plans provide the same level of coverage for acupuncture as Original Medicare. It also includes the same procedures and medical treatment. However, some Medicare Advantage plans may expand acupuncture coverage to treat other conditions.

To find an MA plan that covers acupuncture, use our Personal Shopper.

Do any Medicare Supplement Insurance (Medigap) policies cover acupuncture? 

Medicare Supplement Insurance Policies (also known as Medigap) do not cover acupuncture. However, there is one exception: Innovative Plan G in California.

What Medicare Part D plan covers acupuncture? 

Medicare Part D is a type of plan that provides prescription drug coverage. There are no Medicare Part D plans that cover acupuncture. You can receive acupuncture for chronic low back pain under Original Medicare Part B or an MA plan. 

Use our Personal Shopper to find an MA plan that covers acupuncture benefits.

Medicare acupuncture fee schedule 

Original Medicare Part B covers acupuncture sessions for chronic low back pain only. As with other services covered by Part B, the member is responsible for 20% of the Medicare-approved amount after paying the Part B deductible (which is $240 in 2024). Medicare Part B then pays 80% of the approved amount. If an individual receives treatment in addition to those covered by Medicare, they pay the total amount out-of-pocket.

Who can provide acupuncture under Medicare? 

The member must get acupuncture from a doctor, or another health care provider (like a nurse practitioner or physician assistant) who has both of the below.

• A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine.
• A current, full, active and unrestricted license to practice acupuncture in the state where the member receives care.

Not all providers can give acupuncture. And Medicare can’t directly pay Licensed Acupuncturists for their services.

Questions about Medicare?

Shoot us an email: enrollment@attainhealth.com