Prior to January 21st, 2020 acupuncture was nationally not covered by Medicare. With the growing popularity of acupuncture and studies that shows the effectiveness of acupuncture for pain management, an important milestone was reached.
According to the decision memo for Acupuncture for Chronic Low Back Pain released by Centers for Medicare & Medicaid Services (CMS) under section 1862(a)(1)(A) of the Social Security Act. Medicare is now covering for chronic low back pain up to 12 visits in 90 days. Chronic low back pain is defined as 12 weeks or longer; nonspecific, in that it has no identifiable systemic cause (i.e., not associated with metastatic, inflammatory, infectious, etc. disease); not associated with surgery and not associated with pregnancy.
While this is great news and shows major improvement for the acupuncture field, there is one important thing to note about this decision memo. Acupuncturists are sadly not covered under Medicare, not yet at least.
If acupuncturists are not covered, who can treat the patients with acupuncture? According to the decision memo, only physicians, physician assistants, nurse, clinical nurse specialist and auxiliary personnel are qualified. Below is a direct quote from the decision memo, can also view the full content by clicking on this link.
Physicians (as defined in 1861(r)(1)) may furnish acupuncture in accordance with applicable state requirements.
Physician assistants, nurse practitioners/clinical nurse specialists (as identified in 1861(aa)(5)), and auxiliary personnel may furnish acupuncture
All though acupuncturists are still not covered at this time however this is a big step towards the right direction. Acupuncture had been gaining popularity, with more and more patients asking for acupuncture coverage. Hopefully not long down the road, acupuncturists will also be added to the CMS list of approved providers.
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