Medicare began to cover Acupuncture in 2020. However, it is still not covered when rendered under an Acupuncturist license. When the Centers for Medicare and Medicaid Services (CMS) announced their decision to cover acupuncture for chronic low back pain, it generated much confusion among the acupuncture community. While this may be a move in the right direction, as it currently stands, it does not allow for an acupuncturist to bill Medicare.
There are certain requirements one must meet in order to be able to bill Medicare for acupuncture. Medicare dictates that treatment must be administered under the “adequate supervision” of a physician, physician assistant, or nurse practitioner. Unfortunately, acupuncturist do not fall under the term of “adequate supervision” and services must be rendered under an MD/DO, physician assistant, nurse practitioner, clinical nurse specialist, or auxiliary personnel all of which disqualify an acupuncturist. They must also “possess a master’s or doctoral-level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine (ACAOM)” and hold a “current, full, active, and unrestricted license to practice acupuncture” in the state.
In summary, in order to be able to bill to Medicare as an acupuncturist, you must be working under direct supervision of an MD/DO, physician assistant, or nurse practitioner plus the practitioner must also be a Medicare provider. If you have any questions please feel free to reach out to us, we are always happy to help.
