Acupuncture Services
Under Medicare enrollment rules, licensed acupuncturists are not recognized as eligible practitioners and therefore cannot bill Medicare directly.
Medicare covers acupuncture services for chronic lower back pain (CLBP) under Section 1862(a)(1)(A) of the Social Security Act when coverage requirements are met; however, not all practitioner types are eligible to furnish the service.
Physicians and certain non-physician practitioners, including nurse practitioners, clinical nurse specialists, physician assistants, and qualified auxiliary personnel, may furnish Medicare-covered acupuncture services when applicable CMS qualification and state licensure requirements are met.
When Completing the Medicare Enrollment CMS-855I Application or its equivalent in the Provider Enrollment, Chain and Ownership System (PECOS), include a copy of acupuncture license and proof that applicable education requirements have been completed.
References
- Decision Memo for Acupuncture for Chronic Low Back Pain
- CMS IOM Pub.100-03 Medicare National Coverage Determination Manual, Chapter 1, Part 1 Section 30.3
- NCD: Acupuncture for Chronic Lower Back Pain (cLBP) (30.3.3)
- Welcome to the Medicare Provider Enrollment, Chain, and Ownership (PECOS)
- Medicare Enrollment Application - Physicians and Non-Physician Practitioners CMS-855I