Analysis of 2020–2023 Medicare Part B data reveals significant geographic disparities following the federal coverage decision for chronic low back pain

WHITTIER, Calif., March 25, 2026 /PRNewswire/ — Southern California University of Health Sciences (SCU) announced new research findings demonstrating more than a 100-fold variation in Medicare beneficiaries’ access to acupuncture across the United States. The findings were presented at the Academy of Integrative Health & Medicine (AIHM) Conference.

The study analyzed Medicare Part B claims data from January 2020 through December 2023, following the Centers for Medicare & Medicaid Services (CMS) decision in January 2020 to cover acupuncture for chronic low back pain.

The research was conducted under a National Institutes of Health (NIH) R01 grant titled “Acupuncture for Medicare Beneficiaries with Chronic Low Back Pain: Access, Utilization, and Outcomes” (Grant No. 1R01AT012615-01A1).

The analysis found dramatic geographic disparities in both utilization and treatment intensity of Medicare-covered acupuncture services across all 50 states.

What Did the Study Examine?

The research team, led by James Whedon, DC, MS, Senior Health Services Researcher at Southern California University of Health Sciences, evaluated two specific measures:

• Utilization: Number of patients receiving acupuncture per 100,000 Medicare beneficiaries
• Treatment intensity: Number of acupuncture visits per 100,000 Medicare beneficiaries

The data showed that some states had utilization rates more than 100 times higher than others. Treatment intensity closely tracked utilization rates, suggesting systemic differences rather than random variation.

“What surprised us most was the magnitude of the differences,” said Dr. James Whedon, Senior Health Services Researcher at Southern California University of Health Sciences. “There is always some geographic variation in healthcare use, but these disparities were extreme and not easily explained by population size or patient need alone.”

Why Does Medicare Coverage Not Equal Access?

Medicare began covering acupuncture for chronic low back pain in January 2020 as a non-pharmacologic treatment option. However, the study findings indicate that coverage does not necessarily ensure equitable access.

Under current federal policy governed by the Social Security Act, Medicare reimbursement for acupuncture is generally limited to physicians and certain supervised practitioners. Licensed acupuncturists—who complete graduate-level education and clinical training and are licensed under state law—are not recognized as Medicare providers and cannot bill Medicare directly.

“As expected, the data show that the clinicians who are most highly trained in acupuncture are not available to provide acupuncture under Medicare,” Dr. Whedon explained. “The lack of availability is a direct result of barriers to access incorporated into federal health policy.”

In states where physicians or qualifying supervised practitioners are less likely to provide acupuncture services, Medicare beneficiaries may have coverage on paper but limited practical access in their communities.

What Do the Findings Mean for Healthcare Policy?

The study provides federally funded, externally valid evidence that geographic disparities in Medicare acupuncture utilization persist six years after coverage was approved.

The research is part of an ongoing NIH-funded initiative examining access, utilization, and patient outcomes associated with acupuncture for Medicare beneficiaries with chronic low back pain.

“Policy makers and healthcare advocates need high-quality data to justify their positions,” said Dr. Whedon. “Our research provides evidence to support informed decision-making regarding Medicare provider eligibility and access to non-pharmacologic pain care.”

Additional analyses from the grant-funded project are currently underway.

About the Research

• Funding Agency: National Institutes of Health (NIH)
• Grant Mechanism: R01
• Grant Number: 1R01AT012615-01A1
• Study Period: January 2020 – December 2023
• Data Source: Medicare Part B claims data
• Presentation Venue: Academy of Integrative Health & Medicine (AIHM) Conference, October 2025

About Southern California University of Health Sciences

Southern California University of Health Sciences (SCU) is one of the world’s only Integrative, Whole Health universities—teaching students to blend the best of conventional medicine with proven complementary approaches, and to treat the whole person (body, mind, and spirit). Founded in 1911, SCU has been challenging convention and pushing healthcare forward for more than 100 years. Today, the institution offers graduate, undergraduate, and certificate programs in a wide range of disciplines, including Chiropractic, Sports Medicine, Physical & Occupational Therapy, Genetic Counseling, Genetics & Genomics, Medical Science, Physician Assistant, Ayurveda, Acupuncture & Chinese Herbal Medicine, Clinical Psychology, Whole Health Leadership, and beyond. Learn more at scuhs.edu.

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SOURCE Southern California University of Health Sciences