Study Reveals Massive 'Care Deserts' for Medicare Acupuncture Access

WHITTIER, CA – March 25, 2026 – A landmark study funded by the National Institutes of Health (NIH) has uncovered staggering geographic disparities in access to acupuncture for Medicare beneficiaries, revealing a more than 100-fold variation between states. The research, conducted by a team at Southern California University of Health Sciences (SCU), demonstrates that a 2020 federal decision to cover acupuncture for chronic low back pain has not translated into equitable access, creating a postcode lottery for millions of American seniors seeking non-pharmacologic pain relief.

The findings, presented at the Academy of Integrative Health & Medicine (AIHM) Conference, analyzed four years of Medicare Part B claims data from 2020 to 2023. They expose a deep disconnect between policy and practice, where federal coverage on paper is undermined by systemic barriers that prevent patients from receiving care.

"What surprised us most was the magnitude of the differences," said Dr. James Whedon, Senior Health Services Researcher at SCU and the study's lead author. "There is always some geographic variation in healthcare use, but these disparities were extreme and not easily explained by population size or patient need alone."

The Coverage Paradox

In January 2020, the Centers for Medicare & Medicaid Services (CMS) made a significant policy shift by approving coverage for acupuncture to treat chronic low back pain. The decision was widely seen as a positive step toward addressing the opioid crisis by providing a safe, non-drug alternative for a condition that affects millions of older adults.

Under the policy, Medicare Part B beneficiaries are eligible for up to 12 acupuncture sessions within a 90-day period. If a patient shows improvement, an additional eight sessions can be authorized, for a total of 20 treatments annually. To qualify, the low back pain must have lasted for 12 weeks or longer and have no identifiable systemic cause, such as cancer or infection.

However, the promise of this coverage is being severely limited by a critical detail in the federal rules governing who can provide and bill for these services. This regulatory hurdle, rooted in the Social Security Act, has become the primary driver of the access crisis highlighted in the SCU study.

A Systemic Barrier to Access

The core of the problem lies in Medicare's definition of an eligible provider. Currently, only physicians (MDs and DOs), physician assistants (PAs), and nurse practitioners (NPs) can bill Medicare directly for acupuncture services. While these providers can perform acupuncture if they meet state licensing and training requirements, the nation's most highly trained and numerous acupuncture specialists—licensed acupuncturists (L.Ac.s)—are excluded from direct billing.

Licensed acupuncturists typically complete a three-to-four-year master's or doctoral degree program focused exclusively on acupuncture and Chinese medicine. Yet, under federal law, they are not recognized as independent Medicare providers. They can only provide services "incident to" a supervising physician, PA, or NP, a model that is often impractical in clinical settings and creates significant administrative and logistical burdens.

"As expected, the data show that the clinicians who are most highly trained in acupuncture are not available to provide acupuncture under Medicare," Dr. Whedon explained in the announcement. "The lack of availability is a direct result of barriers to access incorporated into federal health policy."

This exclusion means that in regions where few physicians or nurse practitioners have integrated acupuncture into their practice, Medicare beneficiaries are left with a covered benefit they cannot use. The SCU study's metrics on utilization (patients receiving care) and treatment intensity (number of visits) both pointed to this systemic failure, with rates in some states over 100 times higher than in others.

A Postcode Lottery for Pain Relief

The research reveals a stark map of inequality. States on the West Coast, in parts of the Northeast, and in some northern prairie regions demonstrated higher rates of acupuncture use among Medicare beneficiaries. In contrast, vast swaths of the South and interior United States have become effective "care deserts," where access is virtually nonexistent.

This disparity is compounded by a patchwork of state-level regulations. While most states license acupuncturists, the rules governing their scope of practice and the ability of other medical professionals to perform acupuncture vary widely. The federal billing restriction sits on top of this complex state landscape, creating near-insurmountable obstacles in many areas.

For seniors with chronic low back pain, this means their ability to access a covered, effective, and non-addictive treatment depends entirely on their zip code. Those in low-access states are left with fewer options, potentially leading to continued reliance on pain medications, including opioids, or more invasive and costly procedures—the very outcomes the CMS coverage decision was intended to help prevent.

Data-Driven Push for Policy Change

Advocates argue that the solution is straightforward: amend the Social Security Act to recognize licensed acupuncturists as Medicare providers. A bipartisan bill, the Acupuncture for Our Seniors Act, has been introduced in Congress to do just that. If passed, it would allow qualified L.Ac.s to bill Medicare directly, dramatically expanding the network of available providers across the country.

Professional organizations like the American Society of Acupuncturists (ASA) and the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) are actively lobbying for this legislative change, arguing it is a common-sense fix that would align Medicare policy with the reality of the U.S. healthcare workforce and improve health outcomes for seniors.

The research from SCU, backed by a prestigious NIH R01 grant, provides the robust, federally funded evidence that can fuel this policy debate. It moves the conversation beyond anecdote and provides a clear, data-driven picture of a policy failing to meet its objective.

"Policy makers and healthcare advocates need high-quality data to justify their positions," Dr. Whedon stated. "Our research provides evidence to support informed decision-making regarding Medicare provider eligibility and access to non-pharmacologic pain care."

As the project continues to analyze patient outcomes, the findings will likely add further weight to the argument that for Medicare coverage to equal access, the providers most qualified to deliver the care must be allowed to participate fully in the system.