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CMS Acupuncture for Fibromyalgia Form

Effective Date

01/21/2020

Last Reviewed

NA

Original Document

  Reference


Related policies from health plans


Background for this Policy


A. General

Acupuncture is the selection and manipulation of specific acupuncture points by a variety of needling and non-needling techniques.


B. Nationally Covered Indications

N/A for acupuncture for fibromyalgia.

C. Nationally Non-Covered Indications

Effective for claims with dates of service on and after April 16, 2004, after careful reconsideration of its initial non-coverage determination for acupuncture, the Centers for Medicare & Medicaid Services (CMS) concludes that there is no convincing evidence for the use of acupuncture for pain relief in patients with fibromyalgia. Study design flaws presently prohibit assessing acupuncture’s utility for improving health outcomes. Accordingly, CMS determines that acupuncture is not considered reasonable and necessary for the treatment of fibromyalgia within the meaning of §1862(a)(1) of the Social Security Act, and the national non-coverage determination for acupuncture for fibromyalgia continues.

D. Other

N/A

(This NCD last reviewed April 2004.)