Center for Medicare Services Now Covers Acupuncture for Low Back Pain

As of January 2020, the Centers for Medicare & Medicaid Services (CMS) has approved coverage for acupuncture treatments specifically aimed at relieving lower back pain. Though limited in scope, this decision is a major step towards improving access to non-pharmaceutical therapies for chronic pain. 

If you’ve suffered from lower back pain, you know how excruciating it can be. While certain pharmaceutical drugs may have provided you with temporary relief, the negative side-effects and long-term risks, including addiction, are significant. As the nation continues to combat the opioid crisis, medical providers are searching for alternative therapies to address low back pain. As of January 2020, the Centers for Medicare & Medicaid Services (CMS) formally agreed to cover acupuncture specifically designed to treat low back pain. While the ruling only applies to acupuncturists who are employees of physicians’ offices, this is still a major step toward offering more varied and holistic therapies for individuals who are suffering from lower back pain.

An Effective Alternative to Pharmaceutical Treatment

Over the last few decades, those who suffered from acute or chronic low back pain were often prescribed various drugs to block or reduce the sensation of pain. Instead of addressing the root of the issue, these drugs offered temporary relief that usually came with undesirable—or even dangerous—side-effects. As we discussed in a previous blog post, Many individuals relied heavily on nonsteroidal anti-inflammatories (NSAIDs), including Advil, Tylenol, or aspirin, to dull their lower back pain. However, using NSAIDs for prolonged periods of time can increase your risk for developing heart disease or cause severe liver damage. When doctors prescribed powerful opioids, such as hydrocodone, oxycodone, or Fentanyl, many patients became addicted to these drugs, contributing to the current opioid epidemic the U.S. is still facing.

In 2017, the American College of Physicians (ACP) began to advocate for alternative therapies as a first response to lower back pain before turning to medication. Moderate exercise, stretching, yoga, heat therapy, and massage became the primary therapies to address lower back pain, with the hope that many patients would find relief before they ever needed to turn to pharmaceuticals. Even though acupuncture has been used by communities around the world to relieve lower back pain for centuries, it has only recently become the subject of small clinical studies to determine its effectiveness. While more studies have yet to be done, preliminary results indicate that people suffering from chronic low back pain report that acupuncture treatments relieve their pain and improve their overall function.

Recognizing the Power of Acupuncture as Therapy

As the medical sphere began to explore alternatives to pharmaceutical treatment, CMS decided to conduct its own evidence reviews and evaluate the various coverage policies of private payers in order to reach its final ruling. Kimberly Brandt, the Principal Deputy Administrator of Operations and Policy for CMS, stated: “We are dedicated to increasing access to alternatives to prescription opioids and believe that covering acupuncture for chronic low back pain is in the best interest of Medicare patients.” This decision marks an important step towards providing more non-pharmaceutical treatment options to members of the public, especially to more vulnerable populations, such as low-income and elderly individuals. By offering acupuncture coverage for those experiencing lower back pain, CMS is increasing public access to a safe and effective treatment program that carries no negative side-effects.

Specifics About the New CMS Coverage

While the new coverage is fairly limited in scope, it is still a meaningful place to start. For now, the coverage applies only to acupuncturists who are employed by an M.D., P.A., or N.P. The acupuncturist will not be compensated directly; instead, payments will be made to the medical provider who employs the acupuncturist. The coverage applies only to individuals suffering from chronic lower back pain, meaning it must be present for at least twelve weeks. Medicare patients will be covered for up to 12 acupuncture sessions within a 90-day period, with the possibility of receiving up to an additional 8 sessions who are demonstrating improvement. Even though independent acupuncturists are not yet covered by this new decision, CMS has drawn attention to the benefits of acupuncture as a method for relieving and treating lower back pain.

Find Relief Today

If you are experiencing persistent low back pain, Inner Works Acupuncture is here to help you find long-lasting relief. Reach out to our Portland clinic by calling (503) 227-2127 to schedule an appointment today.

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