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Major Disparities in Access to Medicare Acupuncture

A groundbreaking study from the Southern California University of Health Sciences (SCU) has uncovered alarming disparities in access to acupuncture for Medicare beneficiaries across the United States. Conducted under the auspices of the National Institutes of Health (NIH), the research shows that access to acupuncture varies more than 100-fold depending on the state. These findings were recently presented at the Academy of Integrative Health Medicine (AIHM) Conference.

Research Overview

The study analyzed Medicare Part B claims data from January 2020 to December 2023, in response to the Centers for Medicare & Medicaid Services' (CMS) decision to cover acupuncture treatment for chronic low back pain starting January 2020. Led by Dr. James Whedon, a Senior Health Services Researcher at SCU, the research evaluated both the utilization of acupuncture—measured by the number of patients receiving acupuncture per 100,000 Medicare beneficiaries—and treatment intensity, indicated by the number of acupuncture visits per 100,000 beneficiaries.

The results were striking; some states exhibited utilization rates for acupuncture that were over 100 times higher than others, and treatment intensity mirrored this disparity. Dr. Whedon noted the sheer magnitude of these differences was surprising, highlighting that while regional variations in healthcare are common, these findings indicate a significant systemic issue rather than random variation.

Understanding the Disparities

While acupuncture has been covered by Medicare since early 2020, the study highlights a critical nuance: coverage does not guarantee access. Current federal policy restricts who can bill Medicare for acupuncture services. Only physicians and certain supervised practitioners are able to provide these services, leaving licensed acupuncturists, who undergo rigorous graduate education and clinical training, without the ability to bill Medicare directly. This policy creates a considerable barrier for patients seeking acupuncture treatment.

Dr. Whedon elaborated on this challenge, stating, "The data show that the clinicians highly trained in acupuncture are not available for Medicare beneficiaries, leading to a paradoxical situation where individuals may have coverage, but lack real access to treatments in their communities."

In states where physicians are less inclined to offer acupuncture services, beneficiaries find that although they have potential coverage on paper, their access to these treatments is severely limited.

Implications for Healthcare Policy

This research presents compelling evidence of geographic disparities in the utilization of Medicare-covered acupuncture services, revealing a persistence of these issues six years after the initial coverage approval. As part of a broader NIH-funded initiative, this study serves to inform policy-makers and healthcare advocates about the systemic barriers that hinder access to acupuncture for those who could benefit from it.

Dr. Whedon emphasizes the importance of high-quality data for justifying policy positions, stating, "Our findings provide the evidence necessary for informed decision-making regarding Medicare provider eligibility and improving access to non-pharmacologic pain management options."

As additional analyses from the NIH-funded project continue, the hope is that this research will spur necessary changes in federal policy, ensuring more equitable access to acupuncture therapies for Medicare beneficiaries across all states.

About the Study

• - Funding Agency: National Institutes of Health (NIH)
• - Grant Mechanism: R01
• - Grant Number: 1R01AT012615-01A1
• - Study Period: January 2020 – December 2023
• - Data Source: Medicare Part B claims data
• - Presentation Venue: Academy of Integrative Health Medicine (AIHM) Conference, October 2025

About SCU

The Southern California University of Health Sciences is at the forefront of integrative health education, blending conventional medicine and proven complementary approaches. With over 100 years of experience, SCU offers diverse academic programs aimed at preparing students to treat the whole person. To learn more, visit scuhs.edu.