Medicare will cover acupuncture services for beneficiaries with chronic low back pain, the CMS said on Tuesday.
People enrolled in Medicare will be able to receive up to 12 acupuncture treatments during a 90-day period if they have non-specific lower back pain that lasts 12 weeks or more, but not if it's not associated with surgery or pregnancy. They will be eligible for eight more sessions if their symptoms improve, but Medicare won't cover more than 20 sessions each year.
The Trump administration said that it reviewed scientific evidence and the coverage policies of private payers to reach its decision.
"Expanding options for pain treatment is a key piece of the Trump administration's strategy for defeating our country's opioid crisis," HHS Secretary Alex Azar said. "Medicare beneficiaries will now have a new option at their disposal to help them deal with chronic low back pain, which is a common and sometimes debilitating condition."
Congress and the administration have sought to expand coverage for non-opioid pain management treatments to reduce the healthcare system's reliance on opioids to treat pain and cut down on substance use disorder.
Acupuncture providers and some patient advocates have pushed for private and public payers to cover acupuncture services, which they say offer patients relief from pain without the risky side effects of opioids.
Payers and many providers have raised concerns about the effectiveness of acupuncture as a viable therapy. The evidence that acupuncture is an effective treatment for chronic lower back pain isn't especially strong, especially because many of the studies on acupuncture are relatively low quality. But it's also a low-risk treatment option that could help some seniors.
Commercial insurers have had problems figuring out how to pay for acupuncture treatment because there is no standardized licensing and treatment practices vary.