Acupuncture for Chronic Low Back Pain Approved for Medicare Beneficiaries – With Caveats

Acupuncture for Chronic Low Back Pain Approved for Medicare Beneficiaries – With Caveats

In a press release dated January 21, 2020, the Centers for Medicare & Medicaid Services (CMS) announced its decision to cover acupuncture for Medicare patients with chronic low back pain.

While this is welcome news, CSOMA would like to clarify some areas of potential confusion.

California licensed acupuncturists (LAcs), including those with doctoral titles, may not furnish acupuncture under the Medicare program, unless under the appropriate level of supervision (physician, physician assistant, or nurse practitioner/clinical nurse specialist).

Why? Per the Decision Summary, acupuncturists are not recognized by CMS as Medicare providers, and are not eligible to bill for acupuncture services.

This fact could be overlooked, given that the same document outlines the following:

“Physician assistants, nurse practitioners/clinical nurse specialists (as identified in 1861(aa)(5)), and auxiliary personnel may furnish acupuncture if they meet all applicable state requirements and have:

  • A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine (ACAOM); and
  • Current, full, active, and unrestricted license to practice acupuncture in a State, Territory, or Commonwealth (i.e. Puerto Rico) of the United States, or District of Columbia.”

Despite fitting this criteria to furnish acupuncture under the Medicare program, licensed acupuncturists are considered auxiliary personnel, and as such –

“Auxiliary personnel furnishing acupuncture must be under the appropriate level of supervision of a physician, physician assistant, or nurse practitioner/clinical nurse specialist required by our regulations at 42 CFR §§ 410.26 and 410.27.”

Mike Morgan, CSOMA President remarked, “This decision by CMS brings us one step closer to getting acupuncture approved for licensed acupuncturists in California and nationally, so that we can deliver this medicine to all populations in need, regardless of healthcare coverage.”

In a joint letter from the ASA and NCCAOM, it was noted, “This is a monumental step towards improving access to acupuncture and licensed acupuncturists for all Americans, and we should take a moment to enjoy this evolution, which was many years in the making.”

For complete details, see the Decision Memo for Acupuncture for Chronic Low Back Pain.

CSOMA will provide updates on the topic as they become available.

Posted in:
Advocacy & Legislation Acupuncture for Chronic Low Back Pain Approved for Medicare Beneficiaries – With Caveats