We’re covering acupuncture for Medicare Advantage members

Retroactive to Jan. 21, 2020, Medicare Plus Blue℠ and BCN Advantage℠ members have coverage for acupuncture to treat chronic low back pain, or cLBP. We cover up to 12 visits in 90 days for qualifying patients who’ve had chronic low back pain, defined as:

• Lasting 12 weeks or longer
• Nonspecific, in that it has no identifiable systemic cause (for example, not associated with metastatic, inflammatory or infectious disease)
• Not associated with surgery
• Not associated with pregnancy

We’ll cover eight additional visits for patients showing improvement, but no more than 20 visits annually. Treatment must be discontinued if the patient doesn’t improve or regresses.

Medicare doesn’t cover any type of acupuncture, including dry needling, for conditions other than cLBP.

Providers can offer this service if they meet all applicable educational and state licensing requirements. For more information on these requirements, refer to the Centers for Medicare & Medicaid Services’ Decision Memo for Acupuncture for Chronic Low Back Pain.**

This decision is based on CMS’ National Coverage Determination for Acupuncture for Chronic Low Back Pain and doesn’t apply to Blue Cross or BCN commercial members.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.