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Due to legislation changes, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) covers acupuncture services for Medicare Advantage members. Not all providers offer acupuncture service. Please review the list of acupuncture providers to find providers in your area that may offer acupuncture.
For more information, you can refer to the CMS decision summary.
Last Updated May 2023
The Blue Cross North Carolina (Blue Cross NC) provider directory is created from information provided by our network providers, facilities and third parties. We try to provide you with the most up-to-date and accurate provider lists. However, providers are added to our network often and sometimes decide not to participate in our network. We cannot always guarantee that these provider lists are accurate or current when you search.
Legislative changes in the Social Security Act now allow for coverage of acupuncture services under MA plans when specific clinical and professional criteria are met. Under the updated legislation, Blue Cross NC covers acupuncture for chronic low back pain under section 1862(a)(1)(A) of the Social Security Act for our Medicare Advantage Plans. More information can be found at Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N) (cms.gov).
Under updated legislation, Blue Cross NC will cover acupuncture services for chronic low back pain under section 1862(a)(1)(A) of the Social Security Act for our Medicare Advantage Plans. Up to 12 visits in 90 days are covered for Medicare beneficiaries under the following circumstances:
For the purpose of this decision, chronic low back pain (CLBP) is defined as:
- Lasting 12 weeks or longer;
- Nonspecific, in that it has no identifiable systemic cause (i.e. not associated with metastatic, inflammatory, infectious, etc. disease);
- Not associated with surgery; and
- Not associated with pregnancy.
- An additional eight sessions will be covered for those patients demonstrating an improvement. No more than 20 acupuncture treatments may be administered annually.
- Treatment must be discontinued if the patient is not improving or is regressing.
Blue Cross North Carolina (Blue Cross NC) does not credential or contract directly with acupuncture providers, however, we are asking our participating MA providers to self-report their ability to offer acupuncture services. Below, you will find providers that have indicated that they may perform some acupuncture services. To be covered, these services still need to meet the criteria outlined by Centers for Medicare and Medicaid Services (CMS). Members should contact the provider directly to ensure these services are offered.
Providers listed are contracted with both HMO and PPO products for Medicare Advantage.
Practice Name | Phone Number | Street Address | City | State | Zip |
|---|---|---|---|---|---|
A Woman’s Place in Fayetteville | 2053 Valley Gate Dr., Suite 201 | Fayetteville | NC | 28304 | |
Atrium Health Wake Forest Baptist Integrative Medicine – Highland Oaks | 755 Highland Oaks Dr., Suite 102 | Winston Salem | NC | 27103 | |
Carolina Neurosurgery & Spine Associates | 225 Baldwin Ave. | Charlotte | NC | 28204 | |
Delina H Bishop, MD | 478 Williamson Rd. | Mooresville | NC | 28117 | |
Duke Private Diagnostic Clinic | 40 Duke Medicine Circle | Durham | NC | 27710 | |
EmergeOrtho PA | Multiple locations | ||||
FryeCare Generations Family | 2810 16th Street NE | Hickory | NC | 28601 | |
Goldsboro IM & Spa | 1600 Wayne Memorial Drive | Goldsboro | NC | 27534 | |
Guilford Orthopaedic | 1915 Lendew Street | Greensboro | NC | 27408 | |
Integrative Medicine – Highland Oaks | 755 Highland Oaks Drive | Winston Salem | NC | 27103 | |
NorthEast Internal & Integrative Medicine | 707 Memorial Blvd. | Concord | NC | 28025 | |
Rex Neurosurgery and Spine Center | 4207 Lake Boone Trail | Raleigh | NC | 27607 | |
Urgent Care Clemmons | 2311 Lewisville-Clemmons Rd. | Clemmons | NC | 27103 | |
Valley Physical Medicine | 3706 Morganton Rd. | Fayetteville | NC | 28303 |
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