Acupuncture Services Now Covered for Certain Conditions

January 4, 2023

The World Trade Center (WTC) Health Program now covers acupuncture services as part of the treatment for the following certified WTC-related health conditions:

• Certified WTC-related cancer
• Cancer medically associated with a certified WTC-related health condition
• Chronic pain resulting from a certified WTC-related acute traumatic injury
• Chronic pain resulting from a certified WTC-related muscular skeletal disorder
• Chronic pain resulting from a condition medically associated with a certified WTC-related acute traumatic injury or muscular skeletal disorder

The Program aligns with Medicare when developing policies for covered services. Medicare began covering acupuncture in 2021 and now the Program has changed the acupuncture coverage policy to align with Medicare. This may mean that some members that previously received acupuncture service will see a change in their benefit.

For additional information on acupuncture service coverage, see the WTC Health Program Administrative Manual – Acupuncture Services.

What acupuncture services are covered?

Acupuncture services now available for coverage through the WTC Health Program include traditional acupuncture with needles. They also include other acupuncture services involving heat, pressure, friction, suction, and electromagnetic impulses.

These services must be received by a licensed acupuncture provider in the network of your Clinical Center of Excellence or the Nationwide Provider Network. For Survivors, this provider should also be in your primary health insurance network to ensure coordination of benefits can be completed.

Who can authorize the use of acupuncture?

The Clinical Director of a WTC Health Program Clinical Center of Excellence or the Nationwide Provider Network can authorize acupuncture services as part of the treatment for a certified WTC-related cancer or a cancer medically associated with a certified WTC-related health condition.

The WTC Health Program must authorize the use of acupuncture services as part of the treatment for a certified WTC-related acute traumatic injury or muscular skeletal disorder. The Program also must authorize acupuncture for a condition medially associated with a certified WTC-related acute traumatic injury or muscular skeletal disorder.

Once authorized, talk to your Clinical Center of Excellence or the Nationwide Provider Network to ensure that the acupuncture service provider is in their network and the treatment will be covered by that provider. For Survivors, this acupuncture service provider should also be in your primary health insurance network so that coordination of benefits can occur.

How many acupuncture visits are covered?

The Program will cover twelve (12) acupuncture visits in ninety (90) days if certain criteria for authorization are met. More visits may be authorized if additional criteria are met. No more than twenty (20) visits may occur per twelve (12) months.

Where can I get more information on acupuncture coverage?

More information on the addition of acupuncture coverage is available in the WTC Health Program Administrative Manual.

What about other alternative or complementary therapies?

Acupuncture is the only alternative or complementary therapy available through the WTC Health Program at this time. Alternative or complementary therapies¹ that are not currently covered include, but are not limited to, spinal adjustments, massage therapy, and meditation.

The Program will continue to assess the viability and scientific efficacy of other alternative or complementary therapies, especially when and if they are offered by other federal government-based healthcare programs. The Program aligns to other federal government-based healthcare programs such as Medicare as much as possible.

If you would like to advocate for coverage of additional alternative or complementary therapies, you may write a letter to the Administrator of the WTC Health Program at the address on the Contact Us page.

1. Additional Reference: Complementary, Alternative, or Integrative Health: What’s In a Name? | NCCIH (nih.gov)