Sponsors (21)
The bill expands Medicare coverage to include acupuncture—broadening non-opioid pain-treatment options and creating provider billing opportunities—while increasing Medicare costs and administrative burdens and risking limited access if payment rates deter provider participation.
Medicare beneficiaries will gain Medicare coverage for acupuncture services 270 days after enactment, expanding access to non-opioid pain treatment options.
Licensed acupuncturists and physicians can bill Medicare separately for acupuncture, creating new revenue opportunities for practitioners and institutional providers.
The bill recognizes licensed acupuncturists and directs the Secretary to specify criteria where State licensure does not exist, creating national standards that improve workforce clarity and patient safety.
Covering acupuncture will increase Medicare spending and could put upward pressure on Part B premiums or federal spending, affecting taxpayers and beneficiaries.
If Medicare payment rates for acupuncture are set too low or are unclear, some providers may not participate, which would limit actual access despite coverage being authorized.
States without existing acupuncture licensure may incur administrative burdens to coordinate with HHS criteria and create certification pathways for practitioners to qualify for Medicare billing.
Based on analysis of 2 sections of legislative text.
Adds qualified acupuncturist services to Medicare Part A and B coverage, defines qualified providers, and updates payment and billing rules for reimbursement.
Adds coverage of "qualified acupuncturist services" to Medicare Part A and Part B by amending the Social Security Act. The bill defines who counts as a qualified acupuncturist (state-licensed practitioners, or individuals meeting Secretary-set criteria where no state licensure exists, and physicians authorized by state law), and updates Medicare payment and billing rules so these providers and services are recognized for reimbursement. The change takes effect for services furnished on or after 270 days after enactment and requires Medicare rulemaking to incorporate new practitioner definitions, billing codes, and payment policies under existing physician fee schedule and institutional payment rules.
Introduced February 27, 2025 by Judy Chu · Last progress February 27, 2025