Sponsors (25)
The bill expands Medicare coverage to include acupuncture—broadening access to non-opioid pain treatment and new payment opportunities for providers—while increasing federal costs and creating implementation, licensure, and administrative challenges.
Medicare beneficiaries gain Medicare coverage for acupuncture, increasing access to non-opioid pain treatment options.
Hospitals and institutional providers can receive separate payment for inpatient acupuncturist services, encouraging integration of acupuncture into inpatient care.
Licensed acupuncturists and qualifying practitioners can bill Medicare under the physician fee schedule, creating a new revenue source and expanding provider opportunities.
Taxpayers and Medicare beneficiaries face increased federal spending and potential higher program costs due to expanded coverage.
Medicare beneficiaries and practitioners may see inconsistent provider eligibility and access across states because state licensure varies and the Secretary must apply criteria, producing uneven implementation.
Hospitals, providers, and CMS will face increased billing complexity and administrative burden during implementation (new coding, billing rules, accreditation), which could slow adoption and raise compliance costs.
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 physician payment and billing rules.
Introduced February 27, 2025 by Judy Chu · Last progress February 27, 2025
Adds coverage of qualified acupuncturist services to Medicare Part B, defining who counts as a qualified acupuncturist and making acupuncture services payable under Medicare’s existing physician payment and billing rules. The law requires CMS to treat licensed acupuncturists (or, where a State has no acupuncturist licensure, persons meeting Secretary-established criteria such as national certification, and physicians authorized by State law) as eligible providers and makes acupuncture separately payable for institutional and inpatient settings. Changes take effect for services furnished on or after 270 days after enactment, and adjust several Medicare billing and payment rules so acupuncture is reimbursed under the physician fee schedule and billed like other practitioners.