Does Medicare Cover Acupuncture in 2020?

Medicare does cover acupuncture in 2020. In this article, you will find out how many acupuncture visits are covered and which medical condition is treatable by acupuncture. Moreover, you will learn what acupuncture is, who can administer it, and the story of Mary’s acupuncture experience. Ultimately, you will discover that acupuncture is a safer pain management alternative to opioids, especially for seniors.

Medicare Covers Acupuncture

On January 21, 2020, CMS announces Medicare Part B covers up to 12 acupuncture visits in 90 days for chronic lower back pain. Before this date, Medicare did not cover acupuncture. Medicare.gov defines chronic back pain as follows:

  • Lasting 12 weeks or longer
  • Having no identifiable systemic cause (not associated with metastatic, inflammatory, or infectious disease)
  • Pain that is not associated with surgery or pregnancy

Moreover, an additional eight sessions for a total of 20 treatments will be covered if you show improvement. However, if your doctor decides your chronic lower back pain is not improving or gets worse, then Medicare will not cover your acupuncture treatments. Furthermore, Medicare does not cover acupuncture for any condition other than chronic lower back pain. Now you know Medicare covers acupuncture, so what exactly is it?

What is Acupuncture?

medicare accupuncture

Acupuncture is the practice of penetrating the skin with thin, solid, metallic needles at specific Acupuncture is the practice of penetrating the skin with thin, solid, metallic needles at specific points on your body. In traditional Chinese medicine, acupuncture is most commonly used to treat pain. As shown in the photo, acupuncture needles are very thin like a strand of hair, and the needle length is 1.5 inches. Acupuncture uses these needles to stimulate points on your nerves, muscles, and connective tissue. So who can administer acupuncture treatments, and is it safe?

Acupuncture Practitioners

Medicare Part B requires the acupuncture practitioner to be a licensed health care provider. For example, a doctor, nurse practitioner, or physician assistant can administer acupuncture. Moreover, practitioners must have a master’s or doctoral-level degree in acupuncture or Oriental Medicine. These licensed practitioners use sterile single-use, disposable needles. So the risk of infection is minimal, but does it hurt?

Mary’s Acupuncture Experience

medicare accupuncture experience

Mary is a senior diagnosed with osteoporosis. Like many senior women, Mary’s bones have become weak and brittle over the years. As a result, she suffers from chronic lower back pain. Mary wants to go walking with her grandkids, but it’s too painful on her back. She calls her doctor and makes an appointment.

At doctor Anderson’s office, he asks Mary what’s wrong? Mary says, “I have been having lower back pain for the last three months.” The doctor exams Mary and says, “I can prescribe oxycodone for the pain.” Mary looks intensely at the doctor and shouts, “No! My sister died from an opioid overdose.” Dr. Anderson recalls drug overdose deaths from the CDC:

2018 Drug Overdose Deaths

OxyContin Oxycodone pills
OxyContin also called Oxycodone is an addictive opioid.

“I’m sorry about your sister,” says Dr. Anderson. After a moment of silence, Dr. Anderson says, “Acupuncture is a safer alternative to opioids.” Mary listens to the doctor and learns how Medicare Part B covers acupuncture treatments for lower back pain. Then Mary makes an appointment with a licensed acupuncture practitioner. 

Mary lies down on her stomach, concerned the needles will hurt when they penetrate her skin. Doctor Lee, the acupuncture practitioner, inserts the needles. Mary is relieved she does not feel them. Then Dr. Lee applies mild electrical pulses to the needles, and Mary feels a tingling sensation down her back. After about 15 minutes, the acupuncture session is over. 

Mary’s Acupuncture Results

After a few weeks of acupuncture, Mary’s lower back pain improves. Mary starts going on walks with her grandkids. Best of all, Mary got pain relief without the overdose danger of opioids. After 90 days, Mary has a follow-up appointment with Doctor Anderson. He is happy to hear Mary’s lower back pain has improved and adds eight more acupuncture sessions.

Medicare Acupuncture Conclusion

You learned you could get up to 20 Medicare acupuncture treatments per year for chronic lower back pain. Moreover, you learned acupuncture is the practice of penetrating the skin with metal needles administered by licensed acupuncture practitioners. Furthermore, you learned that Mary got relief from lower back pain through acupuncture, which is a safer alternative than opioids. To get acupuncture, you need Medicare Part B.

Medicare Part B Application

Seniors new to Medicare can apply for Medicare Part B. Learn how you can apply for the safety of your home. You can download the Part B application, fill it out, mail or fax it to your local Social Security office. Robert Bache shows you how to apply for Medicare Part B online in a video. So you can complete the entire Part B application online.