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National Coverage Analysis (NCA) Tracking Sheet for Acupuncture for Fibromyalgia (CAG-00174N)

Acupuncture involves shallow piercing of the skin with small needles at specific points. Traditional Chinese practitioners theorize that the points connect with energy conducting meridians, affecting spiritual, emotional, mental, and physical balance of the opposing forces of yin and yang. Western scientists suggest that stimulation with the needles may enhance or inhibit nerve conduction.

Fibromyalgia is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments and tendonsthe fibrous tissues in the body.

A Requestor has asked that CMS change the current national coverage determination from one of non-coverage of acupuncture to allow national coverage of this therapy. CMS will review the scientific evidence and determine if this procedure would be a reasonable and necessary service for Medicare beneficiaries.

Incident to a physician's professional Service
Inpatient Hospital Services
Physicians' Services
Requestor Name(s)Mr. Jay Silverman
Formal Request Accepted and Review Initiated12/02/2002
Expected NCA Completion Date08/18/2003
Public Comment Period01/02/2003 - 02/02/2003
Decision Memo Released10/10/2003
Lead Analyst(s)
  • Samantha N. Richardson
Lead Medical Officer(s)
  • Lawrence Schott, MD, MS
  • Carlos Cano, MD

December 2,2002

CMS staff worked with requestor to complete formal request, including gathering appropriate evidence, and formally accepted request today for review.

February 26, 2003

CMS has requested a Technology Assessment (TA) from the Agency for Healthcare Research and Quality (AHRQ) on for a review of the literature available on acupuncture. The CMS Decision Memorandum will be posted within 60 days of receipt of the TA.

[Date entered in Expected Completion Date field is an approximation.]

June 18, 2003

CMS has received Technology Assessment from AHRQ. It can be found at www.cms.hhs.gov/coverage/download/id83.pdf. Decision will be made in 60 days.

October 10, 2003

Decision Memorandum has been posted to our website.
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