CMS Proposes Payment for Acupuncture
CMS has announced a proposal to cover acupuncture for certain Medicare patients with chronic low back pain (CLBP). To be covered, patients must be enrolled participants either in clinical trials sponsored by the National Institutes of Health or in CMS-approved studies. At present, acupuncture is non-covered by Medicare.
The proposal is in response to the desire to prevent opioid use disorder and to provide more evidence-based non-pharmacologic treatment options for chronic pain. The Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare & Medicaid Services (CMS) and that National Institutes of Health (NIH) are collaborating in this effort. A review was conducted to assess several nonpharmacological interventions, including exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation for CLBP.CMS completed a national coverage analysis (NCA) to accomplish a thorough review of the evidence to determine if acupuncture for CLBP is reasonable and necessary under the Medicare program. As a result, CMS has issued a Proposed Decision Memo and is requesting public comment. View the proposed memo here.