Sponsors (25)
The bill expands Medicare coverage to improve access to acupuncture and non-opioid pain care and creates new billing opportunities for providers and hospitals, but it raises federal program costs and may produce uneven state-by-state access and added administrative burdens.
Medicare beneficiaries will gain coverage for acupuncture, increasing access to non-opioid pain treatment options.
Licensed acupuncturists and qualifying practitioners will be able to bill Medicare under the physician fee schedule, creating a new revenue source for those providers.
Hospitals and institutional providers can receive separate payment for inpatient acupuncturist services, encouraging integration of acupuncture into inpatient care.
Federal taxpayers and Medicare beneficiaries face higher federal spending because expanding Medicare coverage increases program costs.
Medicare beneficiaries and providers may experience uneven access and eligibility across states due to variation in state licensure and reliance on Secretary-defined criteria.
Hospitals, providers, and CMS may incur increased administrative burden and billing complexity during implementation (new coding, billing rules, and accreditation), raising operational costs and transition challenges.
Based on analysis of 2 sections of legislative text.
Adds qualified acupuncturist services to Medicare Part B, defines eligible providers, and makes those services payable under the physician fee schedule with separate billing rules.
Introduced February 27, 2025 by Judy Chu · Last progress February 27, 2025
Adds acupuncture services to Medicare Part B by creating a defined category of "qualified acupuncturist services" and identifying who counts as a qualified acupuncturist. It requires Medicare to pay for those services under the physician fee schedule, allows separate payment rules for institutional and inpatient settings, and directs coverage to begin for services furnished 270 days after the law takes effect. Defines qualified providers as licensed acupuncturists (or, where a State has no licensure, individuals meeting Secretary-specified criteria such as national certification) and physicians authorized by State law, and adjusts billing and payment rules so those services are separately payable and billable in appropriate settings.