Although the most common use for acupuncture is to treat pain, many also get acupuncture to help with other conditions, such as stress, nausea, and more. However, many people are unsure if their health insurance plan covers acupuncture.

Does Medicare pay for acupuncture? 

Yes, Medicare does pay for acupuncture for certain conditions. Medicare Part B will provide some coverage for acupuncture in specific circumstances. In addition, Part C may provide more extensive acupuncture coverage, depending on your chosen plan. If you do not have acupuncture covered by Medicare with your Part C plan, you may have to pay the 20% coinsurance and deductible. 

When did Medicare start covering acupuncture? 

Acupuncture covered by Medicare is a recent addition to Medicare benefits. Medicare began covering acupuncture in certain circumstances on January 21, 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 many conditions for thousands of years. 

What is acupuncture? 

In an acupuncture session, a healthcare provider will insert very thin needles into your skin in specific locations. Many studies indicate that acupuncture is an effective way to treat and manage many types of pain and discomfort. The acupuncturist places hair-thin needles in precise areas on the body depending on the condition you hope to treat. Most say that the needles are not painful when correctly placed.  

How many acupuncture sessions does Medicare cover? 

Medicare will cover up to 12 acupuncture sessions in 90 days. You can get a total of 20 sessions per year covered by Medicare. Medicare offers an additional eight sessions of acupuncture if you show improvement from the first 12 sessions. However, if you are not getting better or your pain worsens, Medicare will not cover the additional sessions.  

Does Medicare cover acupuncture for neuropathy?  

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

Does Medicare cover acupuncture for pain?  

Currently, Medicare covers acupuncture for lower back pain only. Medicare will not cover acupuncture for pain in other areas of the body. Additionally, if acupuncture covered by Medicare does not help with your lower back pain, Medicare will not authorize additional acupuncture treatments. To qualify, your lower back pain must meet specific requirements, including: 

• No known cause — the lower back pain is not a result of cancer or inflammatory or infectious disease; 
• Lasting for 12 weeks or longer; 
• Not associated with pregnancy or surgery; 

Does Medicare cover acupuncture for knee pain? 

Although many people report feeling pain relief in their knee after acupuncture, Medicare does not cover it at this time. Medicare Parts A and B will only cover acupuncture for lower back pain. 

Does Medicare cover acupuncture for neck pain? 

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

Does Medicare cover acupuncture for osteoarthritis? 

Osteoarthritis is a degenerative disease that affects the joints but can also affect the spine. The Centers for Medicare and Medicaid Services determined in 2004 that acupuncture is not an effective treatment for osteoarthritis. As a result, Medicare does not cover acupuncture for osteoarthritis treatment unless it has resulted in chronic lower back pain. 

Does Medicare Advantage cover acupuncture? 

All Medicare Advantage plans cover acupuncture for lower back pain as part of your Original Medicare (Parts A and B) coverage. And some Medicare Advantage plans may provide additional acupuncture coverage. You will need to check your plan to see if it covers any other alternative therapies not covered by Medicare Parts A and B. Certain plans may allow you to get acupuncture for different kinds of pain other than lower back pain.  

Do any Medicare Supplement plans cover acupuncture? 

Medicare Supplement Plans, also known as Medigap plans, do not cover acupuncture. However, there is one exception: Innovative Plan G in California. As a result, the majority of people with Medigap are only eligible for acupuncture for chronic lower back pain that is not cancer-related and not the result of infection or inflammatory disease.  

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

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 at this time. You can receive acupuncture for lower back pain under Medicare Part B. 

Medicare acupuncture fee schedule 

Medicare Part B covers your acupuncture sessions for chronic lower back pain. As with other services covered by Part B, you will be responsible for 20% of the Medicare-approved amount. You will also need to pay the deductible, which is $240 in 2024. Medicare Part B will pay 80% of the approved amount. In addition, if you receive sessions in addition to those covered by Medicare Part B, you will need to pay the total amount out-of-pocket unless your Medicare Advantage Plan covers additional acupuncture visits.  

Who can provide acupuncture under Medicare? 

Medicare will cover 80% of the approved amount for acupuncture if your provider meets specific criteria. Your healthcare provider may be a: 

• Doctor; 
• Nurse Practitioner; 
• Physician Assistant; 

Additionally, your healthcare provider must have a masters or doctorate in Oriental Medicine or acupuncture from an accredited school. You should also check that your provider has a valid license to practice acupuncture in your state. 

Questions about Medicare?

Shoot us an email at medicare@hihella.com.