Changes in Reimbursed Acupuncture Therapy Amidst the COVID-19 Pandemic: A Cross-Sectional Analysis.

BACKGROUND

The COVID-19 pandemic induced a shift to telemedicine, which may have disproportionately affected in-person treatments such as acupuncture therapy.

OBJECTIVES

We measured trends in reimbursed acupuncture between 2018 and 2021. We also measured trends in other types of pain care among patients with low back pain (LBP), which was the most common diagnosis for acupuncture.

RESEARCH

DESIGN

A descriptive, retrospective, and claims-based analysis.

SUBJECTS: The sample included any patient who used their insurance to pay for acupuncture, which was defined using Current Procedural Technology (CPT) codes 97810, 97811, 97813, and 97814. In secondary analysis, the sample included only patients with LBP, which were identified using the International Classification of Diseases, 10th Edition code of M54.5.

MEASURES: We tracked reimbursed acupuncture and patient and provider characteristics associated with reimbursed acupuncture. Among patients with LBP, trends in acupuncture were compared with trends in chiropractic care, physical therapy, psychotherapy, as well as prescription fills for gabapentinoids, muscle relaxants, and opioids.

RESULTS

After increasing between 2018 and 2019, there was a 28% decline in the number of patients receiving reimbursed acupuncture between 2019 and 2020. Although acupuncture use increased between 2020 and 2021, it did not reach pre-COVID-19 levels. Acupuncturists comprised a smaller share of providers who billed insurance for acupuncture while the share of providers who identified as rehabilitation specialists increased. Among patients with LBP, use of acupuncture fell more during COVID-19 compared with other types of pain care.

CONCLUSIONS

The COVID-19 pandemic had a disproportionate impact on acupuncture therapy, which may be driven by a reduction in acupuncturists who billed insurance. Future research should assess the long-term impact of COVID-19 on acupuncture use in the United States.