Acupuncture for Our Seniors Act of 2025
The Acupuncture for Our Seniors Act of 2025 would add coverage for acupuncturist services under Medicare by amending Title XVIII of the Social Security Act. It creates a new category of “qualified acupuncturist services” that can be furnished by a “qualified acupuncturist” (licensed by a state or meeting a nationally recognized certification standard, or a physician legally authorized to perform acupuncture by the state). The bill allows these services to be billed consistently with existing Medicare payment rules (including the physician fee schedule and separate payments for institutional providers) and requires separate inpatient billing for qualified acupuncturist services. The changes take effect for services furnished on or after 270 days after enactment, expanding access to acupuncture for Medicare beneficiaries. In short, the bill formalizes Medicare coverage for acupuncture, sets minimum qualification standards for who can provide it, and integrates payment procedures into current Medicare structures, with a phase-in period after enactment.
Key Points
- 1Coverage expansion: Adds qualified acupuncturist services to Medicare Part B, treating these services as covered under the Medicare program when provided by a qualified acupuncturist and in accordance with state law.
- 2Qualified acupuncturist definition: A qualified acupuncturist is either a state-licensed acupuncturist (or someone in a state without licensure who meets an equivalent certification standard) or a physician who is legally authorized to perform acupuncture in the state where they practice. The Secretary may reference certification standards from recognized certifying bodies.
- 3Incidence to and scope: Services and supplies furnished as an incident to the qualified acupuncturist’s services are covered, as allowed under state law. This aligns acupuncture with existing “incidental to” rules used for other services, under the supervision and permission of the applicable licensing framework.
- 4Payment structure changes: Updates to Medicare payment rules include new references to qualified acupuncturist services in the physician fee schedule, and provisions for separate payment for qualified acupuncturist services in institutional settings. It also adds the qualified acupuncturist as a recognized practitioner in payment policy and allows separate inpatient billing for these services.
- 5Effective date: The amendments apply to services furnished on or after 270 days after enactment, allowing a transition period before coverage begins.