Medicare will cover no more than 20 acupuncture treatments in a year. Medicare Advantage plans — or Medicare Part C plans — are required to offer the same coverage that Medicare Part A and Part B provide, and they may offer additional benefits. Check with the plan provider to see if the plan covers acupuncture under additional circumstances, or covers more treatments.
If you have additional questions about Medicare coverage, visit Medicare. Assisted living. Cataract surgery. Chiropractic care. COVID testing and vaccines. Dental care. Eye exams. Hearing aids. Home health care.
International travel. Related Items: 3 4 23 24 36 37 44 47 The service of "acupuncture" must be performed by a medical practitioner and itemised under item , , , or to attract benefits. These items cover not only the performance of the acupuncture but include any consultation on the same occasion and any other attendance on the same day for the condition for which acupuncture was given.
Items , , and may only be performed by a general practitioner, see Note 4 of 'Medicare Benefit Arrangements' for a definition if the Medicare Australia CEO has received a written notice from the Royal Australian College of General Practitioners RACGP stating that the person meets the skills requirements for providing services to which the items apply.
Other items in Category 1 of the Schedule should not be itemised for professional attendances when the service "acupuncture" is provided. For the purpose of payment of Medicare benefits "acupuncture" is interpreted as including treatment by means other than the use of acupuncture needles where the same effect is achieved without puncture, eg by application of ultrasound, laser beams, pressure or moxibustion, etc.
For more information on the content-based item structure used in this Group, see A. Related Items: Department of Health. Description Updated:. Schedule Fee Updated:. Previous - Item Next - Item LEVEL B A Level B item will be used for a consultation lasting less than 20 minutes for cases that are not obvious or straightforward in relation to one or more health related issues.
Counselling or Advice to Patients or Relatives For items , , 44, 47 and to 'implementation of a management plan' includes counselling services. Medicare does not cover other services a chiropractor might provide or prescribe, such as acupuncture and massage, and Medicare does not cover tests ordered by a chiropractor such as X-ray.
Medicare Part B covers medically necessary physical therapy treatments. These treatments must be performed by a physical therapist who participates in Medicare and prescribed by a doctor who submits documentation showing that you need the treatment. In addition to Medicare Part A and Medicare Part B , there are additional plans that you can purchase to increase your coverage.
Medicare Part C Medicare Advantage plans are private insurance plans that provide the benefits of original Medicare combined with options from private insurance companies. Advantage plans must cover services that Medicare Part B covers, so any Medicare Advantage plan must cover acupuncture at least the same as Medicare Part B.
Part C may deny claims for alternative treatments. If you have a Medicare Advantage plan, ask your provider their policy for other alternative medical treatments. Medigap supplement plans can be purchased to increase the benefits of traditional Medicare coverage.
These supplement plans cover things like deductibles and other out-of-pocket medical expenses. Private insurance plans are the most likely to cover alternative therapies. While the initial cost of private insurance plans may be higher, these plans may reduce costs of alternative therapies.
Medicare can be confusing and hard to navigate. Acupuncture may be an effective treatment for some health conditions that affect seniors, such as rheumatoid arthritis or chronic lower back pain. Beginning January 21, , Medicare Part B covers acupuncture treatment of chronic lower back pain for up to 12 sessions in 90 days and up to 20 sessions per year.
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