Acupuncture Guidelines

Acupuncture is covered only for musculoskeletal conditions and a defined list of non‑musculoskeletal indications (e.g., adjunct oncology care, adjunct mental‑health care, post‑stroke rehab, fibromyalgia, dry eye, chronic prostatitis, IBS, asthma, menopausal symptoms, chronic constipation, allergic rhinitis, and postoperative nausea/vomiting) and is excluded for maintenance, preventive or palliative use, treatments unrelated to the region of complaint, other non‑listed systemic/visceral/CNS/infectious disorders, services lacking outcome measurement, care that replaces/delays necessary treatment, care with contraindicating serious findings, or care exceeding medically necessary frequency/duration. Key requirements: documentation that symptoms are caused by a musculoskeletal condition when claimed, use of standardized outcome measures with quantified clinically meaningful improvement (≥ established MCID/MDC or equivalent) to justify continuation, and appropriate medical co‑management for adjunct indications (oncology, mental health, stroke rehab).