Hey Medicare Nation!
It’s still January…but February is right around the corner. Spring WILL come. I promise!
Let me give you some good news!
Medicare is now covering Acupuncture!
As of January 21, 2020, The Center for Medicare & Medicaid Services (CMS), will cover acupuncture for “Chronic Low Back Pain.”
Let’s look at the coverage in the Medicare National Coverage Determination Manual.
Section 1862(a)(1)(A) of the Social Security Act
Up to “12” visits in 90 days are covered for Medicare Beneficiaries under the following circumstances:
a. Chronic Low Back Pain which lasts “12 weeks or longer,”
b. the Chronic Low Back Pain is “non-specific,” in that it has NO identifiable systemic cause (NOT associated with metastatic, inflammatory, infectious, disease).
c. the Chronic Low Back Pain is NOT associated with surgery
d. the Chronic Low Back Pain is NOT associated with pregnancy.
An ADDITIONAL “Eight” (8) sessions WILL be covered for those patients demonstrating an improvement.
No more than “20” acupuncture treatments may be administered annually.
Treatment MUST be discontinued if the patient is NOT improving or is regressing.
The Acupuncture must be Administered under the supervision of a doctor of medicine or osteopathy.
Which plans cover Acupuncture?
Acupuncture for Chronic Low Back Pain, will be covered under ORIGINAL Medicare.
If you present your Medicare ID Card to providers as your Health Insurance….. You may start utilizing this treatment now.
If you present your Medicare ID Card, as well as a Medi-Gap (Medicare Supplement) Plan….. You may start utilizing this treatment now.
If you have a Medicare Advantage Plan, you need to check your Summary of Benefits Book under your plan, to see if they cover Acupuncture. If you can’t find it…. call the customer service number on the back of your ID Card and ask the representative.
Acupuncture is NOT covered under Medicare Part D. Part D is ONLY for Prescription Drug Coverage.
If you have any questions…send them to Support@TheMedicareNation.com
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