Medicare Covers Acupuncture for Chronic Low Back Pain
Acupuncture Today Staff
The Centers for Medicare & Medicaid Services has announced it will cover acupuncture treatment of chronic low back pain. According to a joint statement from the American Society of Acupuncturists and the National Certification Commission for Acupuncture and Oriental Medicine, "This unprecedented support of a licensure group who is not currently a part of Medicare, as well as the endorsement of our academic system, speaks to the care and trust they put in us, and the desire for Medicare beneficiaries to receive the best care possible."
CMS stipulates that it will cover up to 12 visits for LBP within a 90-day period under the following circumstances:
The pain is chronic (12 weeks or longer).
The pain is nonspecific; "it has no identifiable systemic cause"
The pain is not associated with surgery or pregnancy.
CMS will cover an additional eight acupuncture sessions if patients are shown to demonstrate improvement with treatment (20-treatment limit annually). In addition, "Treatment must be discontinued if the patient is not improving or is regressing."
CMS does not specifically list acupuncturists, but does mention "auxiliary personnel" who can provide (but not bill) treatment under appropriate supervision by a physician .. or a physician assistant / nurse who has also obtained a master's or doctoral degree from an ACAOM-accredited acupuncture institution. The ASA / NCCAOM statement explains:
"Provider types outside of Medicare are by CMS definition 'auxiliary personnel.' Auxiliary personnel must be supervised by Medicare providers. This is the maximal freedom that can be granted until the Social Security Act is amended to include LAcs, by an act of Congress. The power to do that does not lie with CMS, but with our profession."
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