The use of acupuncture was first reported in China approximately 3,000 years ago. Practitioners insert small needles into specific points on the body during acupuncture to relieve pain. Today, acupuncture is a popular and effective non-drug and non-invasive treatment for a variety of health problems.
Medicare Coverage for Acupuncture
Until January 2020, Medicare did not cover acupuncture. But that same month, the Centers for Medicare and Medicaid Services (CMS) announced changes.
“We are committed to increasing access to alternatives to prescription opioids and believe it is in the best interest of Medicare patients to cover acupuncture for chronic low back pain.”CMS Operations and Policy Kimberly Brandt, principal deputy administrator in charge, said in a press release.
Medicare Part B covers up to 12 acupuncture treatments in a 90-day period for chronic back pain. If the patient shows improvement in the first 12 sessions, an additional 8 sessions will be covered, up to a maximum of 20 acupuncture treatments over a 12-month period.
The cost of each session is 20% of the standard Medicare approved amount after meeting the Part B deductible.
What is chronic low back pain?
Many of us suffer from back pain from time to time, and CMS defines chronic back pain covered by Medicare as:
- lasts at least 12 weeks
- No specific cause related to illness or infection
- Not related to surgery or pregnancy
how Cure back pain with acupuncture
Although acupuncture can alleviate a variety of health issues, many studies have shown that it is particularly effective for lower back pain, which is the number one reason people seek acupuncture.
One research review showed that acupuncture provides short-term relief from chronic low back pain. A separate analysis of data from 20 studies on people with low back pain, osteoarthritis, neck pain, or headaches found that for all symptoms except neck pain, the benefits of acupuncture were significant up to 1 year after treatment ended. It turned out that it continued.
How acupuncture works for lower back pain is not fully understood. Acupuncture can directly affect the tissue into which the needles are inserted. It can also trigger the release of endorphins, which essentially stop pain.
Who can provide acupuncture treatment covered by Medicare?
Under current CMS guidelines, certified and degreed acupuncturists may be under the supervision of a resident physician (MD), physician assistant (PA), nurse practitioner (NP), or clinical nurse specialist (CNS). Only can provide acupuncture treatments covered by Medicare. ). This is difficult for many Medicare beneficiaries.
“This is a huge problem,” says Mori West, CPC, insurance chair of the American Association of Acupuncturists and CEO of ACUCLAIMS. , or staff CNS. ”
That means only about 1,000 acupuncturists nationwide can provide services covered by Medicare.
Mr. West has been in contact with CMS to find some workarounds, and Rep. Judy Chu (D-CA) has filed a bill, HR3133 – Acupuncture for Seniors Act of 2023. If passed, the bill would allow acupuncturists to enroll and bill directly to Medicare, eliminating the health insurance system. The need for supervision.
Medicare Advantage Coverage of Acupuncture
Medicare Advantage plans mirror Medicare acupuncture benefits, so they offer the same coverage for chronic back pain. However, health care providers must have a physician on-site to provide acupuncture treatments covered by Medicare.
Some Medicare Advantage plans may cover regular acupuncture treatments for a variety of conditions, including but not limited to chronic back pain, as part of a suite of supplemental coverage.
Medicaid coverage for acupuncture
“Many states offer Medicaid coverage for acupuncture,” says Tuesday Wasserman, a doctor of acupuncture and Chinese medicine and Medicaid chair of the American Association of Acupuncturists.
These states include Washington, Oregon, California, New Mexico, Colorado, Minnesota, Missouri, Illinois, Ohio, Florida, New Jersey, New York, Massachusetts, Connecticut, and Maryland, and coverage varies by state. .
community acupuncture
New, more affordable acupuncture treatments are available in many areas of the country.
“Community acupuncture offers a ‘pay what you can’ or low-cost model where a group of people sit in lounge chairs and receive acupuncture treatment based on their health challenges,” West says.
Led by the People’s Organization of Community Acupuncture, a low-cost acupuncture training school, the organization provides a directory of local acupuncture clinics.
