National Coverage Analysis (NCA) Tracking Sheet

Acupuncture for Osteoarthritis



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.

Osteoarthritis is the most common form of arthritis it occurs in most adults over 60 years of age. Osteoarthritis is also referred to as "degenerative joint disease". It is characterized by the breakdown of the joint's cartilage. Cartilage is the part of the joint that cushions the ends of bones. Cartilage breakdown causes bones to rub against each other, causing pain and loss of movement.

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.

Benefit Category

Incident to a physician's professional Service
Inpatient Hospital Services
Physicians' Services

Requestor Information

Requestor Name Requestor Letter
Mr. Jay Silverman N/A

Important Dates

Formal Request Accepted and Review Initiated
Expected NCA Completion Date
Public Comment Period
01/02/2003 - 02/02/2003
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released


Lead Analysts
Samantha N. Richardson
Lead Medical Officers
Lawrence Schott, MD, MS
Carlos Cano, MD

Medicare Benefit Category Determination Date

Actions Taken

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) 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.]

July 7, 2003

CMS has received Technology Assessment from AHRQ. It can be found at Decision will be made in 60 days.

October 10, 2003

Decision Memorandum has been posted to our website.