It’s only Tuesday and this week alone, I have had 2 phone calls, 3 messages on social media, and someone who physically came into my office with a print out of both the home page of my website AND the Acupuncture page from Medicare.gov hoping to make an appointment to use Medicare benefits that allegedly cover Acupuncture.
Sadly, I had to tell each one of them that I would be unable to bill Medicare for my services, and that they would be very unlikely to be able to find a practitioner in our area that fits the criteria for Medicare reimbursement for Acupuncture services. Here’s why:
At https://www.medicare.gov/coverage/acupuncture it states:
Medicare Part B (Medical Insurance) covers up to 12 acupuncture visits in 90 days for chronic low back pain.
Medicare covers an additional 8 sessions if you show improvement. If you aren't showing improvement, Medicare won't cover your additional treatments and they should be discontinued. You can get a maximum of 20 acupuncture treatments in a 12-month period.
Unfortunately, it ALSO states:
Not all providers can give acupuncture, and Medicare can't directly pay Licensed Acupuncturists for their services. Medicare also doesn't cover acupuncture (including dry needling) for any condition other than chronic low back pain.
(You can check out the screen shot that accompanies this blog post, because prior to my chat with this customer service rep, this language was NOT on their website. You’re welcome and I’m sorry to be the bearer of bad news. Special thanks to Cindy who did indeed escalate the issue.)
You must get acupuncture from a doctor, or by another healthcare provider (like a nurse practitioner or physician assistant) who has both of these:
A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine
A current, full, active, and unrestricted license to practice acupuncture in the state where you're getting care
The reasons for this are complex and have to do with bureaucratic red tape that may or may not be resolved in the next few years, but the bottom line is, Medicare patients are, by and large, unable to access their Acupuncture benefits, unless they can find an MD who is willing to bill Medicare, or an NP or PT who has ALSO graduated from an accredited Acupuncture college and maintains a full, active acupuncture license, and is willing to bill Medicare.
If and when the situation changes, we will update this post, but at this time, Fitchburg Acupuncture does not and cannot bill Medicare for Acupuncture services of any kind. Please feel free to call Medicare, and your Senators & Reps to complain if this bothers you. Please do NOT be mean and hang up on me like the lady who called me around lunchtime on Monday.
That hurt my feelings.
Allison Blaisdell, MSTOM, Lic.Ac. is a licensed acupuncturist and herbalist in private practice at Fitchburg Acupuncture, and also at Massachusetts General Hospital. She offers Acupuncture, Hypnosis, Nutritional Response Testing, and Frequency Specific Microcurrent, as well as online holistic health coaching and consultation. Her mission is to educate and empower her patients to achieve their best possible health.