Introduction
Acupuncture has been used for centuries to treat a variety of medical conditions. In recent years, more and more people have turned to this ancient form of healing to help alleviate pain and reduce stress. But does Medicare cover acupuncture? If you’re looking into acupuncture treatments, you may be wondering if Medicare will help cover the costs.
This article explores the benefits of acupuncture and whether Medicare covers it, as well as how to get covered for acupuncture care with Medicare. We’ll also provide a comprehensive guide to Medicare coverage for acupuncture, so you can make an informed decision about your health care needs.
How to Get Covered for Acupuncture Care with Medicare
If you are considering acupuncture treatments, it’s important to understand what Medicare covers and how you can maximize your coverage. Here’s what you need to know about Medicare coverage for acupuncture:
- Medicare Part B covers medically necessary acupuncture treatments performed by a licensed acupuncturist.
- The treatments must be related to a diagnosis that is covered by Medicare.
- You must receive the treatments at a Medicare-approved facility.
- Your doctor or other healthcare provider must certify that the treatments are medically necessary.
- You may have to pay a deductible and coinsurance for each acupuncture treatment.
Breaking down Medicare’s coverage for acupuncture treatments can help you understand how much of the cost will be covered by Medicare. Generally speaking, Medicare pays 80% of the approved amount for medically necessary acupuncture treatments, after you meet your annual deductible. You will be responsible for the remaining 20%, plus any additional fees charged by the acupuncturist.
A Comprehensive Guide to Medicare Coverage for Acupuncture
Now that you know the basics of Medicare coverage for acupuncture, let’s take a closer look at the details. Does Medicare cover acupuncture? Yes, but there are certain criteria that must be met in order to be eligible for coverage.
First, the treatments must be performed by a licensed acupuncturist. The acupuncturist must be certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Second, the treatments must be related to a diagnosis that is covered by Medicare. Third, you must receive the treatments at a Medicare-approved facility. Finally, your doctor or other healthcare provider must certify that the treatments are medically necessary.
It is important to note that not all acupuncture treatments are covered by Medicare. For example, Medicare does not cover treatments such as cupping, moxibustion, and gua sha. Additionally, Medicare does not cover acupuncture treatments for cosmetic purposes.
In addition to the above criteria, you may also have to pay a deductible and coinsurance for each acupuncture treatment. Your deductible is the amount you must pay before Medicare begins to cover your treatments. After you meet your deductible, Medicare will typically cover 80% of the approved amount for medically necessary acupuncture treatments. You will be responsible for the remaining 20%, plus any additional fees charged by the acupuncturist.
Conclusion
Acupuncture is an ancient form of healing that has been used for centuries to treat a variety of medical conditions. While Medicare does provide coverage for some types of acupuncture treatments, there are certain criteria that must be met in order to be eligible for coverage. It is important to understand the specifics of Medicare coverage for acupuncture, so you can make an informed decision about your health care needs.
In summary, Medicare Part B covers medically necessary acupuncture treatments performed by a licensed acupuncturist. The treatments must be related to a diagnosis that is covered by Medicare, and you must receive the treatments at a Medicare-approved facility. Your doctor or other healthcare provider must also certify that the treatments are medically necessary. You may also have to pay a deductible and coinsurance for each acupuncture treatment.
Finally, here are a few tips to help you maximize your coverage: Make sure the acupuncturist is certified by the NCCAOM, ask your doctor or other healthcare provider to certify that the treatments are medically necessary, and find out if your plan includes any additional coverage for acupuncture treatments.
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Hello, I’m a licensed acupuncturist, yup like the ones described in your piece that must be board certified by NCCAOM and licensed. I also receive many, many phone calls per day with patients INSISTING their medicare policy covers acupuncture because of articles like this.
I’ve been practicing for 20 years, I’ve seen acupuncture go from voodoo to now just about fully accepted by main stream medicine. And I’ve been part of the fight to gain acceptance and acknowledgement that this medicine is evidence-based and helping many people with non pharmaceutical alternatives.
Unfortunately, we’re not quite there yet. Yes, the medicare book says acupuncture is an included services for chronic low back pain and 12 visits per year are allowable when performed by a practitioner who is licensed to practice acupuncture and board certified by the NCCAOM. HOWEVER, and here’s where they get us, Medicare does not ALLOW licensed acupuncturists into their network! So, acupuncturists can not BILL MEDICARE. This basically makes the allowed service unusable because good luck finding a provider that is dual licensed in acupuncture and another modality that allows billing to medicare. Most acupuncturists completed their (minimum) 3 years of post graduate training and began practicing. They didn’t also complete an MD/PA/NP degree so they could bill medicare for practicing acupuncture.
I know what a joke! Medicare announces in 2020 they cover acupuncture but they really don’t! Want more info? Rep Judy Chu of California has been presenting a bill before congress for several years to close this loop hole and allow licensed aucpuncturists into the Medicare system, Acupuncture for Seniors Act. It hasn’t passed yet. https://chu.house.gov/media-center/press-releases/rep-chu-introduces-acupuncture-seniors-act-2021
Want acupuncture actually covered by Medicare? Talk to your reps about supporting this bill!