Medicare does cover acupuncture for the treatment of chronic lower back pain. This means that you may be able to get some coverage for acupuncture treatments if you have Original Medicare coverage (Medicare Part A and Part B).
Medicare Advantage (Part C) plans will also cover acupuncture for lower back pain treatment, and some plans may cover other types of alternative therapy or pain management treatments.
Most Medicare Advantage plans also offer Medicare prescription drug coverage.
Does Medicare pay for acupuncture and physical therapy?
Medicare Part B (medical insurance) will cover acupuncture for up to 12 sessions in 90 days, with an additional 8 sessions for beneficiaries who show improvement in their chronic lower back pain.
Medicare Part B can also help cover physical therapy.
Beginning in 2018, Medicare no longer caps how much it will pay for physical therapy services in a single year, as long as your therapy services are deemed medically necessary by your therapy provider.
If your physical therapy or acupuncture is covered, Medicare Part B typically pays 80 percent of the Medicare approved amount, and you pay 20 percent after your Part B deductible is met. In 2020, the Medicare Part B deductible is $198 per year.
If your physical therapy or acupuncture is not deemed medically necessary by your therapist, Medicare will not cover the services, and you will be responsible for 100% of the costs.
Your therapist must give you written notice before providing services that are not medically necessary. From there, you can choose whether or not to accept the services and pay for them 100% out of pocket.
Do Medicare Advantage plans cover acupuncture?
Medicare Advantage plans cover the same benefits that are offered by Original Medicare, includes acupunture treatment for beneficiaries who are suffering from chronic lower back pain.
Many Medicare Advantage plans also provide benefits that Original Medicare does not – such as prescription drug benefits or coverage for dental or vision care.
Some Medicare Advantage plans may provide coverage for other types of alternative medicine. Check directly with your plan carrier to find out what forms of therapy may be covered by your plan.
If your physical therapy or acupunture is covered by Medicare Part B, it should also be covered by a Medicare Advantage plan. If you’re enrolled in a Medicare Advantage plan, speak with your insurance company about how your plan will cover your physical therapy.
If you’d like to learn more about Medicare Advantage and compare Medicare Advantage plans that may be available in your area, call today to speak with a licensed agent.
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