Some MA plans offer expanded acupuncture coverage. For example, there are UnitedHealthcare Medicare Advantage plans that cover acupuncture for pain relief and nausea. CareFirst BlueCross BlueShield includes routine acupuncture in its enhanced Medicare Advantage plan.
Full Answer
Does Medicare Advantage cover acupuncture?
Medicare Advantage plans are required to provide, at a minimum, the same coverage for services that beneficiaries receive under Original Medicare Parts A and B. As such, acupuncture is covered under some circumstances by all Medicare Advantage plans. Original Medicare and Acupuncture
What are Medicare Advantage plans (MA plans)?
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).
Do Medicare Advantage plans include drug coverage?
Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services.
How many acupuncture sessions do I need for pain relief?
You’ve got a new pain-relief option: We now cover 12 acupuncture sessions each year as part of your plan.* No referrals necessary! It’s easy to try.
Does Medicare supplement pay for acupuncture?
Since Medicare Supplement plans work alongside Original Medicare coverage, they typically wouldn't cover acupuncture. Even though Medicare Supplement Plan F* provides the most comprehensive basic benefits for Original Medicare's out-of-pocket costs, it would generally not cover acupuncture.
Does Blue Shield Medicare Supplement cover acupuncture?
Benefits offer access to more than 2,400 acupuncturists1 in the American Specialty Health Network who offer acupuncture for conditions related to pain. Covered services include: Initial and subsequent examinations. Acupuncture.
Does MassHealth cover acupuncture?
Effective January 21, 2022, MassHealth will cover acupuncture services under MassHealth Standard, MassHealth CarePlus, and MassHealth CommonHealth, as well as for certain MassHealth Family Assistance members. This letter transmits a new Acupuncture Services provider manual.
Can an acupuncturist enroll in Medicare?
“Currently, acupuncturists are not recognized by CMS as Medicare providers, and are not eligible to bill for acupuncture services. It is possible, however, for acupuncturists to provide acupuncture as auxiliary personnel 'incident to' a physician's service in certain settings.
Why does Medicare not pay for acupuncture?
Why Doesn't Medicare Cover Acupuncture? Mostly, Medicare doesn't cover acupuncture (outside of relief for chronic lower back pain) because this treatment is still considered naturopathic care. For those with chronic pain in other places, you'll likely need to see a pain management specialist.
What diagnosis codes does Medicare cover for acupuncture?
Medicare covers acupuncture (CPT codes 97810-97814) for people with chronic low back pain (M54. 5, Low back pain), effective January 21, 2020. You will get a denial if your treatment exceeds the frquency limitations: Your patients can have up to 12 covered sessions in 90 days.
Does BMC Healthnet cover acupuncture?
Health Net of California, Inc. (Health Net) has partnered with American Specialty Health Plans of California, Inc. (ASH Plans) to provide acupuncture coverage for our members.
Does MassHealth pay for gym memberships?
Eligible Tufts Health Together (MassHealth) members can receive a reimbursement of up to $30 once every calendar year for a gym membership or fitness-related activity.
What does MassHealth CommonHealth cover?
MassHealth CommonHealth pays for medical and other services such as: inpatient hospital care. outpatient medical needs: access to hospitals, clinics, doctors, dentists, family planning, and vision care.
What is the Medicare rate for acupuncture?
Medicare doesn't cover acupuncture (including dry needling) for any condition other than chronic low back pain. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.
When did Medicare start covering acupuncture?
2020Medicare began covering acupuncture in early 2020 partly as an alternative to prescription medications — particularly opioids — for low back pain management.
Does Medicare cover acupuncture for arthritis?
Acupuncture may be an effective treatment for some health conditions that affect seniors, such as rheumatoid arthritis or chronic lower back pain. Beginning January 21, 2020, Medicare Part B covers acupuncture treatment of chronic lower back pain for up to 12 sessions in 90 days and up to 20 sessions per year .
What is an acupuncture license?
A current, full, active, and unrestricted license to practice acupuncture in the state where care is being provided
Does Medicare cover acupuncture?
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. Medicare doesn't cover acupuncture (including dry needling) for any condition other than chronic low back pain.
What is the email address for acupuncture?
If your practice offers acupuncture services, please provide practice information and respond to the questions below via email at
When is treatment discontinued?
Treatment must be discontinued if the patient is not improving or is regressing.
Does Blue Cross offer acupuncture?
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) does not credential or contract with Acupuncture providers, however, we are asking our participating MA providers to self-report their ability to offer acupuncture services. This will enable us to display on our Find a Doctor portal those participating providers that offer acupuncture services.
Does Social Security cover acupuncture?
Legislative changes in the Social Security Act now allow for coverage of acupuncture services under MA plans when specific clinical and professional criteria are met. More information can be found at Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N) (cms.gov) and outlined below under “Additional Information”.
Can an auxiliary file a claim with the Blue Cross?
Auxiliary Personnel are not able to file the claim directly to Blue Cross NC. The claim must be filed under the supervising physician.
Can I practice acupuncture in Puerto Rico?
If yes to either question (2-3), please confirm if service provider has (1) A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine (ACAOM); (2) and a current, full, active, and unrestricted license to practice acupuncture in a State, Territory, or Commonwealth (i.e. Puerto Rico) of the United States, or District of Columbia.
How much does Medicare pay for acupuncture?
If your physical therapy or acupuncture is covered, Medicare Part B typically pays 80 percent of the Medicare approved amount, and you pay 20 percent after your Part B deductible is met. In 2020, the Medicare Part B deductible is $198 per year. If your physical therapy or acupuncture is not deemed medically necessary by your therapist, ...
How long does acupuncture last on Medicare?
Medicare Part B (medical insurance) will cover acupuncture for up to 12 sessions in 90 days, with an additional 8 sessions for beneficiaries who show improvement in their chronic lower back pain. Medicare Part B can also help cover physical therapy.
Does Medicare cover alternative medicine?
Some Medicare Advantage plans may provide coverage for other types of alternative medicine. Check directly with your plan carrier to find out what forms of therapy may be covered by your plan.
Does Medicare Advantage cover prescriptions?
Most Medicare Advantage plans also offer Medicare prescription drug coverage.
Do you have to give a written notice to a therapist?
Your therapist must give you written notice before providing services that are not medically necessary. From there, you can choose whether or not to accept the services and pay for them 100% out of pocket.
Does Medicare cover acupuncture?
Medicare does cover acupuncture for the treatment of chronic lower back pain. This means that you may be able to get some coverage for acupuncture treatments if you have Original Medicare coverage (Medicare Part A and Part B).
How long does acupuncture last?
In fact, some people don’t feel the needles at all. These relaxing sessions usually last 10 to 20 minutes.
What is acupuncture for pain?
It’s an alternative practice that involves stimulating strategic points of the body by inserting thin needles into the skin to alleviate pain. Members often use acupuncture as a complement to other health strategies.
Can holistic medicine be integrated into a holistic health plan?
No, this and any other holistic treatment should be integrated into a complete health and well-being plan.
Can pain be alleviated with regular treatment?
Stiffness, fatigue, and pain may be alleviated with regular treatment.