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Medicare Covered Acupuncture


PacificSource follows original Medicare coverage for acupuncture treatment for Medicare Advantage members.

  • Medicare will cover up to 20 visits
  • Care to be provided by a licensed MD or DO with a license to practice acupuncture
    • PacificSource will allow incident to billing for Medicare covered acupuncture
  • Benefit limited to a diagnosis of Low Back Pain M54.5
  • $25 member cost share on all plans

Please visit to view the original memo.

Should you need additional benefit information, please contact our Customer Service Department.