Does Medicare cover Acupuncture?
Yes, but there are important limitations depending on
which Medicare Part and plan you have.
What is Medicare?
Medicare is a U.S. federal health insurance program
primarily for people 65 and older, and for some individuals
with qualifying disabilities.
Medicare has four main parts:
Part A - “Hospital” insurance
Part B - “Medical” insurance
Part C - Advantage (A + B + more)
Part D - Prescription drug coverage
For the purpose of acupuncture, we will focus on Part B and Part C
Acupuncture & Original Medicare (Plan B)
This is the most confusing part for many patients, and honestly, for many providers too. You might find a local acupuncture clinic in your area, walk in, and ask if they take Medicare. Often, they will say "No." Here is why.
Medicare covers acupuncture only for chronic low back pain, defined as pain lasting 12 weeks or longer with no known structural cause. In 2020, the Centers for Medicare & Medicaid Services (CMS) made this historic decision to cover acupuncture as a non-opioid pain management option. You can read the official CMS decision here.
However, Medicare does not recognize a Licensed Acupuncturist (L.Ac.) as a standalone Medicare provider. To bill Medicare Part B for acupuncture, the treating provider must meet both of these requirements at the same time:
1) They must hold one of the following medical credentials: Medical Doctor (MD), Doctor of Osteopathy (DO), Nurse Practitioner (NP), Physician Assistant (PA), or Clinical Nurse Specialist (CNS).
2) They must also have specific acupuncture training: a master's or doctoral degree in acupuncture or Oriental Medicine from an accredited school, and a current, unrestricted license to practice acupuncture in their state.
This created a very limited pool of eligible providers, because:
Most physicians do not study acupuncture.
Most acupuncturists are not physicians.
Why is this so difficult to find?
This is the number one complaint from Medicare beneficiaries about acupuncture benefit, and it comes down to how the law is written. In the United States, acupuncturists are highly trained specialists who complete 3 to 4 years of graduate-level education specifically in acupuncture and Oriental Medicine. They are experts in their field.
However, the Social Security Act (the law that created Medicare) contains a specific list of recognized "providers" who can be reimbursed. That list includes physicians, clinical psychologists, social workers, and others. It does not currently include Licensed Acupuncturists.
Changing that list requires an Act of Congress. CMS wanted to expand coverage, but they could not add a new provider type on their own. So they created a workaround: acupuncture would be covered, but only when performed or supervised by someone already on the approved list, typically a doctor or nurse practitioner, who also holds an acupuncture degree and license.
What this means for our practice
Because Medicare Part B does not reimburse Licensed Acupuncturists directly, we are currently unable to accept Medicare Part B. This is not a choice, it is a legal limitation that applies to virtually every acupuncture clinic in the country.
There is currently pending federal legislation (The Acupuncture for our Seniors Act) that would change this by allowing licensed acupuncturists to enroll as recognized Medicare providers. This has not yet been passed, but we are following its progress closely and will update our policy if and when that changes. Read more here.
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Acupuncture & Medicare Advantage (Part C)
This is where the good news is — and where many of our patients do have coverage.
Medicare Advantage plans are offered by private insurance companies that are approved and regulated by Medicare. These plans are required to cover everything Original Medicare covers, but they frequently offer additional benefits — and acupuncture is one of the most common additions.
Unlike Original Medicare Part B, private insurance companies have more flexibility in how they build their provider networks. Many Medicare Advantage plans contract directly with Licensed Acupuncturists — which is why finding an in-network acupuncturist under a Medicare Advantage plan is often much easier than under Original Medicare.
We are In-Network with:
Aetna — including Aetna Medicare Advantage plans
United Healthcare — including UnitedHealthcare Medicare Advantage plans and Empire Plan
Cigna — including Cigna Medicare Advantage plans
Humana — including Humana Medicare Advantage plans
If you have a Medicare Advantage plan through one of these carriers, you may have acupuncture coverage at our practice, depending on your specific plan.
We are currently Out-of-Network with Blue Cross Blue Shield and Florida Blue. That does not necessarily mean acupuncture is out of reach — some BCBS and Florida Blue plans do include out-of-network coverage for acupuncture services. A quick call to Member Services can tell you exactly what your plan covers and what your out-of-pocket cost would be.
One Important Note: HMO vs. PPO Plans
Medicare Advantage plans come in two main types, and this affects how you access acupuncture care:
PPO (Preferred Provider Organization) plans — PPO plans offer a larger network of doctors and greater flexibility. They generally allow you to see any in-network provider without a referral. Most straightforward for acupuncture.
HMO (Health Maintenance Organization) plans — HMO plans feature a strict network of local healthcare providers. They require a referral from your primary care physician before your first acupuncture visit. Without a referral, your visits will not be covered.
Please check your plan type before your first appointment. If you have an HMO plan, contact your primary care doctor to request a referral for acupuncture first.
Coverage must be verified before your visit
Every Medicare Advantage plan is different, even plans from the same insurance company. Two patients both enrolled in "Aetna Medicare Advantage" may have completely different benefits. Coverage depends on your specific plan name, plan year, and benefit design.
Before scheduling your appointment, please contact us for insurance verification. At our Palm Beach Gardens clinic, we work with Medicare Advantage patients every day to verify their benefits and make acupuncture accessible. We will need a copy of your insurance card (front & back) and your date of birth to request a verification of coverage from your insurance company.
What to bring to your first visit
Your insurance card
A referral from your primary care physician (if your plan is an HMO)
A photo ID
A list of your current medications and supplements
Any relevant medical records, imaging reports, or lab results related to your condition
Frequently Asked Questions:
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We are in-network with Medicare Advantage plans from Aetna, Humana, United Healthcare, and Cigna. However, being in-network does not guarantee acupuncture coverage — each plan is different. Please contact us for verification of insurance.
We do not currently bill Original Medicare Part B, as federal law does not yet allow licensed acupuncturists to enroll as Medicare Part B providers.
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Not automatically. Your specific plan must include acupuncture as a covered benefit, we must be in-network with your plan, and the condition being treated must be a covered diagnosis. Please contact us for verification of insurance coverage before your first visit.
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The first step is always to verify your acupuncture coverage — please contact us and we will confirm your benefits directly with your insurance company.
If your plan is an HMO and acupuncture is a covered benefit, the next step is to contact your primary care physician to request a referral before scheduling your first visit.
We recommend discussing with your primary care physician the number of visits appropriate for your condition — ideally 12 to 15 visits over a 90-day period (3 months), which allows for at least one treatment per week and gives acupuncture the best opportunity to be effective.
HMO plans will not cover your visits without a referral on file.
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It varies by plan. Many plans cover acupuncture for chronic pain conditions including low back pain, neck pain, and osteoarthritis. Some plans have broader coverage.
Please contact us for verification of insurance coverage to confirm which diagnoses are covered under your specific plan.
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Yes. The Acupuncture for Our Seniors Act is currently pending in Congress. If passed, it would allow licensed acupuncturists to enroll as recognized Medicare Part B providers and bill directly for their services.
We are following this closely and will update our policy accordingly.