Wiki Does Medicare Cover Acupuncture?

[roussj19]

I know as of last year (2020) Medicare started to allow coverage for Acupuncture for chronic low back pain. I have contacted Medicare in the past to see if Acupuncture is covered by a licensed acupuncturist (L.ac), but when contacting medicare & from what I have gathered online it appears acupuncture is covered by a MD, DO, nurse pract, etc. who is also license in AP, etc.

Does anyone have any clarification on this? I have a patient who is convinced Ap is covered by Medicare when performed by a license Ap. I plan on having her sign an ABN, but wanted to see what actually needs to be done in this situation, etc.

Any help would be greatly appreciated, thanks!

 

[SharonCollachi]

Straight from Medicare (click me for link):

Acupuncture​

Medicare Part B (Medical Insurance) covers up to 12 acupuncture visits in 90 days for chronic low back pain.

Medicare covers an additional 8 sessions if you show improvement. If your doctor decides your chronic low back pain isn’t improving or is getting worse, then Medicare won't cover your treatments. No more than 20 acupuncture treatments can be given yearly.

Note
Medicare doesn't cover acupuncture (including dry needling) for any condition other than chronic low back pain.

Your costs in Original Medicare​

Costs details aren’t yet available for this benefit.

What it is​

Acupuncture is a technique where practitioners stimulate specific points on the body, most often by inserting thin needles through the skin.

Things to know​

Chronic low back pain is defined as:

• Lasting 12 weeks or longer
• Having no known cause (not related to cancer that has spread, inflammatory, or infectious disease)
• Pain not associated with surgery or pregnancy

You must get acupuncture from a doctor, or by another health care provider (like a nurse practitioner or physician assistant) who has both of these:

• 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 care is being provided