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Billing / Fees / Insurance

Massachusetts BCBS Covers Acupuncture ... With a Catch

Editorial Staff  |  DIGITAL EXCLUSIVE

Blue Cross Blue Shield (BCBS) of Massachusetts, one of the most progressive state insurers in the nation when it comes to offering non-drug alternatives, has announced it will provide acupuncture coverage beginning Jan. 1, 2020. Eligible members will be able to access acupuncture services for up to 12 visits per calendar year, and referrals are not required. The co-pay will be the same as an outpatient office visit with a specialist.

"We want our members to have access to a broad range of safe, effective treatments for pain management," said Andrew Dreyfus, president and CEO of BCBS of Massachusetts, in a press release announcing the coverage change. "We know our members and employer customers are increasingly seeking alternative treatments like acupuncture, both for chronic conditions and overall wellness."

Now here's the catch: The 12 visits per calendar year are covered when performed by a network provider, "such as a Licensed Acupuncturist, Doctor of Medicine, or Doctor of Osteopathic Medicine." [Italics added].

Acupuncture is included in MD / DO scope of practice in Massachusetts, so this is perhaps more of a state-scope issue, rather than an insurance one. However, it does raise the question of whether covering acupuncture will actually help the AOM profession flourish – in Massachusetts and nationwide – or stunt its growth by blurring the lines between acupuncture provided by an LAc vs. that provided by an MD / DO; particularly as more medical providers look for drug-free tools to combat the opioid crisis.

Editor's Note: Do you care who else can provide acupuncture in your state (as long as you can)? And is "coverage with a catch" better than no coverage at all? We'll explore both topics in AT in 2020.

October 2019
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