tci Medicare Compliance & Reimbursement - 2003 Issue 40

Coverage: DON'T COUNT ON COVERAGE FOR ACUPUNCTURE

CMS nixes requests to cover acupuncture for osteoarthritis, fibromayalgia.  Health care practitioners shouldn't expect Medicare to cover acupuncture for osteoarthritis or fibromyalgia anytime soon. In a pair of recent decision memoranda (CAG-00174N and CAG-00175N), the Centers for Medicare & Medicaid Services' Coverage and Analysis Group decided that there wasn't enough evidence to conclude that acupuncture is reasonable and necessary for those conditions. As a result, CMS will continue its existing noncoverage policy for acupuncture. "While acupuncture may play an adjunctive role to medications for the treatment of pain," CMS says in its memo on osteoarthritis, "data from...

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