FAQ
Does insurance cover acupuncture?
I do accept insurance, but coverage depends on the specific plan benefits. I am happy to do a verification of benefits to determine coverage specifics: number of yearly visits allowed, copay/coinsurance, deductible, and maximum out-of-pocket limits.
I am in-network with Blue Cross/ Blue Shield (and subsidiaries), United Healthcare, Humana, and TriWest. I am an out-of-network (PPO) provider with Aetna and Cigna.
I also accept Workers’ Compensation and Personal Injury cases.
What about Medicare and TriCare?
Unfortunately, I cannot participate with standard Medicare and Medicare Supplemental plans.
However, there are a handful of Medicare Advantage plans that I can participate with (call for details).
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Though Medicare covers acupuncture for chronic low back pain, acupuncturists as a profession cannot enroll as Medicare providers. It takes an act of Congress to amend the Social Security Act to add a new provider designation to Medicare. There is pending legislation to remedy this inconsistency (call your Congressperson to voice your support for the Acupuncture for Our Seniors Act).
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TriCare follows current Medicare guidelines, so I am unable to participate with TriCare.
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Medicare notes the following indications and restrictions for acupuncture:
Acupuncture for Chronic Low Back Pain - Benefit Details
Covered services include: Up to 12 visits in 90 days performed by, or under the supervision of a physician (or other medical provider as described below) are covered for Medicare beneficiaries under the following circumstances: For the purpose of this benefit, chronic low back pain is defined as:
• Lasting 12 weeks or longer;
• nonspecific, in that it has no identifiable systemic cause (i.e., not associated with metastatic, inflammatory, infectious disease, etc.);
• not associated with surgery; and
• not associated with pregnancy.
An additional eight 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.
Generally, Medicare-covered acupuncture services are not covered when provided by an acupuncturist or chiropractor.
Provider Requirements: Physicians (as defined in 1861(r)(1) of the Social Security Act (the Act) may furnish acupuncture in accordance with applicable state requirements.
Physician assistants (PAs), nurse practitioners (NPs)/clinical nurse specialists (CNSs) (as identified in 1861(aa)(5) of the Act), 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,
• a 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.
• Benefit is not covered when solely provided by an independent acupuncturist.
Does acupuncture hurt?
There are sensations associated with acupuncture, but most people do not describe treatments as painful. Many acupuncture points have no noticeable sensation when the needle is inserted. Some points may have a brief sting upon insertion that fades quickly. Other points may have a heavy sensation, that also fades away.
What conditions can acupuncture treat?
Acupuncture can treat chronic and acute pain, injury, and illness. Emergency situations should be evaluated at the hospital before starting acupuncture. Some severe injuries or conditions may require surgery, and although acupuncture can provide temporary relief, the results may not be long-lasting.
How many visits will I need?
As a general guideline, acute conditions respond more quickly, and chronic conditions take longer. I advise my patients that within 3-5 treatments they should show some change in their symptoms (many notice immediate benefits). We may not have reached our goal in that 3-5 visit time-frame, but we should see progress.
The effects of acupuncture are cumulative. If a patient experiences a few days of relief after the first visit, the results should last a little longer with each subsequent visit.
Treatment frequency and duration is determined by the severity and stage of the pain or illness, and how long the effects of treatments last.
What should I do before my visit?
Please wear comfortable, loose-fitting clothing. It’s best to be well-hydrated and have eaten prior to acupuncture treatment. Please forward insurance information so I can verify coverage before the date of service. Lastly, please bring a list of current medications/ dietary supplements, and any relevant medical records.
How long are acupuncture appointments?
The first visit lasts up to 90 minutes. It includes a detailed health history and examination prior to the acupuncture treatment.
Return visits last up to 60 minutes.
What other services do you offer?
In addition to acupuncture, treatment sessions may include manual therapies (e.g. massage), heat therapy, cupping, therapeutic exercises, and herbal medicine. Please note that herbal medicine, if indicated and desired, is an additional cost, and not covered by insurance.
Do I need an appointment?
Yes. All services require an appointment.