This week, Centers for Medicare & Medicaid Services (CMS) shared it will cover acupuncture for chronic low back pain.
The news comes following a series of open comment periods offered by CMS on the topic. We alerted our volunteers to the second comment period earlier this summer, and many of you took the time to respond. The second open comment period saw an impressive 644 submitted comments, most of them patients. (You can read U.S. Pain Foundation’s submitted comments here.)
Why this matters
As an organization, we support public and private payer coverage of acupuncture for people living with all diseases, injuries, and conditions that cause chronic pain. This decision validates the advocacy work of many of us in the pain community, who have been urging CMS to cover more nonpharmacological therapies for chronic pain. While this one modality may not help everyone with chronic low back pain, it’s important that patients have the opportunity to try it. It’s also important because Medicare coverage standards help inform private insurance policy.
Who is eligible
CMS defines chronic low back pain as lasting 12 weeks or longer, and as being nonspecific, in that it has no identifiable systemic cause, is not associated with surgery, and is not associated with pregnancy. Under this new decision, up to 12 visits in 90 days are covered for Medicare beneficiaries who meet the criteria. An additional eight sessions will be covered for those patients demonstrating an improvement; no more than 20 acupuncture treatments may be administered annually, with the treatment being discontinued if the patient is not improving or is regressing. For more details regarding CMS’s decision, click here.
Thanks to those of you who wrote in and helped move the needle on this issue. It’s a clear demonstration of how patient voices can have an impact.