CMS expands coverage of acupuncture

Medicare now covers acupuncture for chronic lower back pain, effective for claims with dates of service on or after January 21, 2020, according to a recently published National Coverage Determination.

Up to 12 visits in 90 days may be covered if the chronic lower back pain has lasted for 12 weeks or longer and is:

• Nonspecific (not caused by an identifiable systemic cause such as a metastatic, inflammatory, or infectious disease)
• Not associated with surgery
• Not associated with pregnancy

If the patient demonstrates an improvement eight more sessions may be covered. The treatment must be discontinued if the patient does improve or regresses, and Medicare will not cover more than 20 treatments annually.