Does Medicare Cover Dry Needling? 

Pain is an unfortunate fact of life for many seniors, and chronic pain can really take its toll on quality-of-life for people dealing with ongoing injuries and illnesses. Seniors who experience chronic pain are often prescribed medications to treat symptoms, but as effective as these medications can be, they also come with some potentially serious side effects.

Some pain medications carry a risk of dependence, and the potential for accidental overdose exists with virtually all pain medications. Additionally, prescription pain medications may cause drowsiness and difficulty with coordination. When these side effects are combined with an increased potential for falls and injuries due to age or mobility concerns, many seniors find themselves looking for alternative treatment options for chronic pain.

Alternative treatments for chronic pain

If you and your doctor have decided that pain management using prescription medications is not the way to go, you may benefit from alternative medical treatments for pain. Transcutaneous electrical nerve stimulation (TENS) is one option that may bring relief, but dry needling is another potential pain management solution that is used to affect specific trigger points around the body. The use of dry needling is a safe method of pain management, and some seniors prefer dry needling to traditional therapies.

How does dry needling work?

Much like acupuncture, dry needling involves the use of very thin needles that are placed just below the skin. These needles rest on trigger points to loosen muscles which may be causing pain and stiffness. The needles do not penetrate muscle tissue, but they do place gentle pressure on fibrous bands of muscle. Physical therapists often provide dry needling treatments, but these treatments may also be provided by a dedicated dry needling specialist. Currently, dry needling is largely unregulated; however, most states have their own requirements for dry needling practitioners.

Does Medicare cover dry needling?

As dry needling is an alternative pain management option sought by many seniors in the United States, Medicare recipients often question whether the program covers dry needling. Unfortunately, Original Medicare insurance does not provide coverage for dry needling at this time. When it comes to using Medicare benefits, one of the main components in a coverage decision is whether or not a service or product is a medical necessity.

Coverage decisions are made by the Centers for Medicare & Medicaid Services (CMS). This is the federal agency that oversees Medicare. CMS has determined that dry needling does not fall within the definition of a treatment that is medically necessary, and therefore, coverage is not extended to dry needling services.

Medicare coverage and acupuncture

Acupuncture is similar to dry needling, but Original Medicare insurance does provide benefits for this treatment. Medicare benefits can be used for up to 12 acupuncture treatments within a 90-day period, but treatment must be prescribed specifically to target chronic lower back pain. If Medicare recipients show improvement from acupuncture treatment, an additional eight treatments are available for a total of 20 within a benefit period.

Medicare Part B typically provides coverage for acupuncture since most treatments are provided in an outpatient setting. If acupuncture is administered in an inpatient setting, Medicare Part A supplies benefits instead.

Does Medicare cover other pain management options?

Although dry needling is not covered by Medicare benefits, the program does provide coverage for a range of pain management treatments. Prescription medications for pain are covered under Medicare Part D, and physical therapy and visits with pain management specialists are covered under Medicare Part B. If you require treatment for pain while hospitalized or admitted to a skilled nursing facility, Medicare coverage is available for all inpatient services through Medicare Part A.

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