On January 21, 2020, CMS announced Medicare acupuncture coverage and chronic lower back pain treatments. Medicare previously did not pay for any ailment treated with acupuncture. Medicare Part B covers out-of-hospital medical treatment.
Participants can have up to 12 sessions over 90 days, with eight additional sessions possible if their symptoms improve. Medicare Part D coverage is expected to last no more than 20 visits spread out over 12 months.
To be covered by the program, the acupuncturist must be a doctor. Licensed medical practitioners with a master’s or doctoral degree and training in acupuncture may perform this treatment.
Medicare has expanded access to no opioid pain management by covering acupuncture. An announcement was made in which it was revealed that the CMS conducted several studies on the use of acupuncture for back pain.
Does Medicare acupuncture service is covered by Advantage Plan?
Part A, B, and D are all paid for by private insurance. This health insurance covers everything, including inpatient and outpatient care and prescription medication. Beneficial policies, such as dental or vision care, tend to be popular among customers.
Medicare Advantage plans provide the same medical services as traditional Medicare. Also, lower back pain treatment instructions are incorporated into the program.
Although many of these healthcare plans include choosing from a restricted list of healthcare providers. Most insurance plans require a physician referral before covering acupuncture costs.
To ensure that they have adequate acupuncture coverage, Medicare Advantage participants may want to speak with their insurance provider.
How does acupuncture help back pain?
People in China are using acupuncture for centuries to treat pain and promote overall well-being. A skilled professional applies tiny needles to stimulate energy flow and alleviate pain in specified body areas.
This process could cause the release of natural pain-relieving chemicals. Acupuncture can help “quiet down” hyperactive pain sensors.
Acupuncture’s effects can last for a long time. Based on a new review of 29 clinical trials involving 17,922 patients, over 90% of patients who received acupuncture reported long-term pain relief.
As with most injections, this procedure has the potential for complications, such as pain or bleeding at the injection site.
How else can acupuncture be used?
Because acupuncture can treat a wide range of medical conditions, practitioners use it to treat them. According to a 2018 article, the US has 37,000 licensed acupuncturists.
Research from the American Academy of Medical Acupuncture suggests the following conditions for which acupuncture may be of benefit:
- Major depression
- Constipation and diarrhoea
- Gynaecological issues
Acupuncture has not been studied to see if it works for many conditions. However, Medicare only covers lower back pain.
Back pain treatments include covered services such as:
Medicare does cover lower back pain when medically necessary, and in truth, it only includes these back pain-related services.
In treating subluxation, Medicare covers chiropractic services. When the spine bones don’t line up, this adds stress and pressure on the nerves in the back, which causes pain.
Medicare Part B covers an approved level of subluxation. Coinsurance applies to Part B as well as Part B’s deductible.
Medicare covers medically necessary outpatient physical therapy.
Physical therapy is often used to work on the back muscles, relieve tension, and help strengthen and stretch the patient. For Part B, deductible and coinsurance requirements apply.
What is left out?
Medicare does not cover any surgery because of the following:
- Nonsurgical chiropractic treatments
Medicare occasionally expands coverage for specific conditions in response to new medical research.
Medicare now accepts acupuncture for chronic lower back pain but not for other kinds of pain. While coverage has increased, people can now access the service widely.
It is critically important to talk to your insurance plan provider to determine whether they are in-network and whether acupuncture treatment requires a referral from a physician.
You can also visit our website NewMedicare.com to learn more.