Medicare Therapy and Pain Management: Coverage Limits and Patient Costs

Adapted from Your Medicare Benefits, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Acupuncture

Acupuncture is a technique where providers stimulate specific points on the body, most often by inserting thin needles through the skin. Medicare only covers acupuncture (including dry needling) for chronic low back pain defined as:

• Lasting 12 weeks or longer
• Having no known cause (for example, it isn’t related to cancer that has spread, or an inflammatory or infectious disease)
• Pain that isn’t associated with surgery or pregnancy

How often Medicare covers up to 12 acupuncture treatments in 90 days for chronic low back pain.

If you show improvement, Medicare covers an additional 8 sessions (for a maximum of 20 acupuncture treatments in a 12-month period). If you aren’t showing improvement, Medicare won’t cover your additional treatments and you’ll pay all costs if you continue getting them.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

Things to know Not all providers can give acupuncture, and Medicare can’t pay licensed acupuncturists directly for their services. You must get acupuncture from a doctor or another health care provider (like a nurse practitioner or physician assistant) who has both a:

• Master’s or doctoral degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission for Acupuncture and Herbal Medicine (formerly the Accreditation Commission on Acupuncture and Oriental Medicine).
• Current, full, active, and unrestricted license to practice acupuncture in the state where you’re getting care.

More information Visit Medicare.gov/coverage/acupuncture.

Chiropractic services

Chiropractic services include techniques (like adjustments to the spine or other parts of the body) to relieve body pain. Part B covers manual manipulation of the spine by a chiropractor to correct a vertebral subluxation (when the spinal joints fail to move properly, but the contact between the joints remains intact).

Medicare doesn’t cover other services or tests a chiropractor orders, including X-rays, massage therapy, and acupuncture.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

More information

• Go to “Acupuncture” on pages 7–8.
• Visit Medicare.gov/coverage/chiropractic-services.

Pain management

Pain management services offer treatment options that may help you manage pain and related issues. Part B covers these pain management services:

• Acupuncture for chronic low back pain: Go to pages 7–8.
• Alcohol misuse screenings and counseling: Go to page 10.
• Behavioral health integration services: Go to page 13.
• Chiropractic services: Go to page 21.
• Chronic pain management and treatment services: Go to page 22.
• Depression screenings: Go to page 33.
• Mental health and substance use disorder services: Go to page 70.
• Occupational therapy: Go to pages 77–78.
• Opioid Use Disorder treatment services: Go to pages 78–79.
• Physical therapy services: Go to page 87.

Medicare drug coverage (Part D) may cover prescription pain medications to treat certain types of short-term pain. If you have Part D, the plan may also have programs (like Medication Therapy Management Programs or drug management programs) to help you use prescription opioid pain medications safely.

Costs

• For most pain management services, you pay 20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies.
• If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.
• You pay nothing for a yearly depression screening if your health care provider accepts assignment.

Things to know Your provider may recommend other pain management treatment options that Medicare doesn’t cover, like massage therapy. If this happens, or if your provider recommends you get services more often than Medicare covers, you may have to pay some or all of the costs. Ask questions so you understand why your provider is recommending certain services and if Medicare will pay for them.

More information

• Visit Medicare.gov/coverage/pain-management.
• For information about medication safety, visit Medicare.gov/health-drug-plans/ part-d/what-plans-cover/plan-rules/safety-management-programs.

Chronic pain management & treatment services

If you have chronic pain (persistent or recurring pain lasting longer than 3 months), management and treatment services can help reduce your pain. Part B covers monthly services for people living with chronic pain. Services may include pain assessment, medication management, and care coordination and planning.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

More information Visit Medicare.gov/coverage/chronic-pain-management-treatment-services.

Physical therapy services

Physical therapy helps to restore or improve physical movement in your body after an injury, illness, or surgery. You can also get this therapy to help improve or maintain your current function, or slow your rate of decline. Part B covers medically necessary outpatient physical therapy services when your doctor or other health care provider (including a nurse practitioner, clinical nurse specialist, or physician assistant) certifies you need them.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

Things to know There’s no limit on how much Medicare pays for your medically necessary outpatient physical therapy services in one calendar year.

More information Visit Medicare.gov/coverage/physical-therapy-services.

Occupational therapy services

Occupational therapy helps you perform activities of daily living (like dressing or bathing). You can get this therapy to help improve or maintain your current capabilities, or to slow your rate of decline. Part B covers medically necessary outpatient occupational therapy if your doctor or other health care provider (including a nurse practitioner, clinical nurse specialist, or physician assistant) certifies you need it.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

Things to know There’s no limit on how much Medicare pays for your medically necessary outpatient occupational therapy services in one calendar year.

More information

• Go to:
• “Home health services” on pages 52–54.
• “Hospice care” on pages 55–57.
• “Inpatient rehabilitation care” on pages 59–60.
• “Mental health care (outpatient): Partial hospitalization” on pages 74–75.
• “Physical therapy services” on page 87.
• “Skilled nursing facility (SNF) care” on pages 103–105.
• “Speech-language pathology services” on page 106.
• Visit Medicare.gov/coverage/occupational-therapy-services.

Speech-language pathology services

Speech-language pathology services provide evaluation and treatment to regain and strengthen speech and language skills. This includes cognitive and swallowing skills, or therapy to improve or maintain current function, or slow your rate of decline. Part B covers medically necessary outpatient speech-language pathology services if your doctor or other health care provider (including a nurse practitioner, clinical nurse specialist, or physician assistant) certifies you need it.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

Things to know There’s no limit on how much Medicare pays for your medically necessary outpatient speech-language pathology services in one calendar year.

More information Visit Medicare.gov/coverage/speech-language-pathology-services.

Source and further reading

Your Medicare Benefits — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.