Who qualifies?
Medicare covers acupuncture for chronic low back pain — including flare-ups of an existing condition — as long as your pain meets all four criteria:
This means that if you’ve lived with chronic back pain for years and are experiencing a flare-up, you may still qualify – even if this particular episode feels new.
Medicare at Mend
If you are experiencing chronic low back pain (12+ weeks) and have Medicare Part B benefits, you are eligible for One-on-One Acupuncture appointments. (No other diagnoses or services are covered by Medicare.)
Appointment Schedule
| Monday | Alexandra, Dani, Yan (Quarry), and Jaqui (Canton) |
| Tuesday | Alexandra (QL), Dani (Rem), and Jaqui (Canton) |
| Wednesday | Alexandra, Dani, Yan (Quarry), and Dana (Remington) |
| Thursday | Yan, Dana (Quarry), Jaqui (Canton) |
| Friday | Yan (Quarry) |
| Saturday | Nurse Practitioner Consults (required before billing Medicare and every six visits) |
Acupuncture for Aging Adults
Many patients, while receiving care for an achy back, enjoy additional benefits as acupuncture regulates the entire nervous system.
As we age, our bodies undergo changes that can lead to chronic pain, arthritis, insomnia, and anxiety. Acupuncture has been shown to help:
While acupuncture is safe for aging adults and has minimal side effects, it should not replace conventional medical care. Always consult with a healthcare provider before starting new treatments.
Frequently Asked Questions
Do I need a referral from my primary care doctor?
No referral needed. Your pre-approval visit with our Nurse Practitioner is all that’s required before you begin treatment.
How do I know if my back pain qualifies?
The simplest test: if your low back pain has lasted 12 weeks or longer and hasn’t been linked to a specific diagnosis like cancer, infection, or recent surgery, there’s a good chance you qualify. Our Nurse Practitioner will confirm during your virtual visit.
What happens at the virtual pre-approval visit?
It’s a short conversation — usually 30 minutes or less. She’ll review your pain history, ask a few questions, and confirm your eligibility for Medicare-covered care. You don’t need to prepare anything special.
How many visits will Medicare cover?
Medicare covers up to 12 visits in your first 90 days. If you’re improving, you can receive up to 8 additional visits — for a maximum of 20 treatments per year.
What if I’m not improving after the first round?
We’ll have an honest conversation with you about next steps. Medicare won’t continue coverage without documented improvement, but we’ll work with you to understand your options.
What will I actually owe?
Medicare covers 80% of the approved amount for both the initial Nurse Practitioner consultation and your acupuncture visits, leaving you responsible for a 20% coinsurance. If you have a supplemental (Medigap) plan, it may cover some or all of that remaining 20%. If your Part B deductible hasn’t been met yet for the year, you’ll be responsible for the full cost of visits until it is. Once it’s met, the 80/20 split applies going forward
Does Medicare cover acupuncture for anything other than low back pain?
Not under Original Medicare. Neck pain, knee pain, headaches, and general wellness visits are not covered. We offer all of these services at Mend on a self-pay basis. If you have secondary insurance through an employer, union, or other source, that plan may cover non-back-pain services depending on your benefits — we are happy to verify your coverage and let you know what you’re eligible for.
I have a Medicare Advantage plan. Am I still eligible?
Yes. All Medicare Advantage plans are required to cover everything Original Medicare covers, including acupuncture for chronic low back pain. Some plans may even offer additional acupuncture benefits. We’ll verify your plan details when you call.
How do I book my virtual pre-approval visit?
Call our front desk or book online. We’ll get you set up with the Nurse Practitioner and take it from there.