Health Insurance Plans
We are currently in network with the insurance plans listed below.
Some insurance plans also offer out-of-network acupuncture benefits. If you’re unsure whether your plan includes acupuncture coverage, or if your plan is not listed below, we encourage you to reach out to our office. Coverage can vary widely by plan, and patients are sometimes surprised by what their insurance allows.
We also recommend contacting your insurance company directly to confirm your specific benefits, including visit limits, copays, and any authorization requirements.
Please note: herbal medicine consultations and the cost of herbs are not covered by insurance and are billed separately from acupuncture treatment, regardless of insurance status.
A Word About Medicare…
Licensed acupuncturists who are not also physicians or other recognized healthcare providers (such as nurse practitioners and physician’s assistants) cannot enroll in Medicare and, therefore, cannot bill Medicare directly for their services.
As much as we would love to be able to accept Medicare at Eventide, the current legislation does not allow it.
In Network Plans
Mass Health
Blue Cross Blue Shield
CCA (Commonwealth Care Alliance)
Wellsense
Mass General Brigham
Mass General Brigham ACO
Humana
Harvard Pilgrim
Acupuncture services are a qualified medical expense eligible for FSA/HSA.
PLEASE CONTACT THE OFFICE IF WOULD LIKE TO USE INSURANCE
We are NOT in network with Medicare. Please do not submit Medicare for verification. Please see “A Word About Medicare” above.
Many insurance companies offer acupuncture benefits but it depends on your individual plan.
Eventide Acupuncture is an in network provider for the health insurance plans listed on this page. Some insurance plans offer out-of-network benefits. Deductibles, Co pays and Co- insurance amounts may apply.
We will verify your insurance prior to care but need AT LEAST 72 HOURS before your appointment to complete verification. In addition, we strongly recommend that YOU call and verify your acupuncture benefits as well. Let’s work together to get you the care you need.
Insurance Disclaimer and Financial Responsibility Notice
While we are happy to bill your insurance as a courtesy, please understand that coverage is not guaranteed. Insurance benefits quoted are NOT a guarantee of payment. It is the patient’s responsibility to know their benefits and to notify us of any changes in coverage.
In the event that your insurance carrier denies payment, discontinues coverage, or does not cover services in full, you will be financially responsible for any remaining balance.
Insurance Coverage FAQ
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No. Insurance verification helps us estimate your benefits, but it is not a guarantee of payment. Coverage decisions are ultimately made by your insurance plan after a claim is submitted and processed.
Insurance information is provided by the plan and can change based on plan details, diagnosis, and medical necessity. For this reason, patients are encouraged to also contact their insurance company directly to confirm benefits. Keeping a record of the representative’s name and reference number can be helpful if questions arise later.
If a claim is denied or adjusted by your insurance plan, any remaining balance becomes the patient’s responsibility.
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Coverage varies by plan, but most insurance policies cover acupuncture primarily for pain-related conditions when the care is considered medically necessary. This generally means treatment is directed toward a specific condition and supported by clinical assessment and response to care.
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“Medically necessary” refers to health care services that are needed to diagnose or treat a medical condition or its symptoms and that meet generally accepted standards of medicine. For insurance purposes, this means a treatment must be appropriate for your condition and reasonably expected to help address it, based on clinical judgment and medical standards.
In practical terms:
The service must be aimed at evaluating or addressing a specific health condition.
It must be considered clinically appropriate (not experimental or cosmetic).
It must align with accepted medical practice for that condition.
It is not just for convenience or general wellness.
For example: if you are being treated for back pain and it improves significantly after a course of several treatments (and we want this to happen!), additional treatment may not be considered ‘medically necessary’ unless there is a clear clinical reason to continue care, such as ongoing symptoms, functional limitations, or recurrence. If treatment continues beyond this point, it may not be covered by insurance and may become the patient’s financial responsibility. If appropriate, we can transition to a self-pay approach for ongoing or maintenance care.
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If a claim is denied, our billing team will typically submit an appeal on your behalf when appropriate. We also encourage patients to file an appeal directly with their insurance plan, as patient-initiated appeals can sometimes influence the outcome.
Insurance coverage decisions are ultimately made by the plan. If coverage is denied after the appeal process, the remaining balance becomes the patient’s responsibility. In that situation, we are happy to discuss a reasonable payment arrangement.
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Some patients choose to self-pay for reasons such as simplicity, privacy, or broader treatment options. Insurance plans often limit covered conditions, visit frequency, or types of care, which may not align with every patient’s goals.
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Being in network means we have a contract with your insurance company, but it does not guarantee coverage under every plan. Coverage depends on your specific plan details, diagnosis, and medical necessity requirements. We recommend confirming benefits directly with your insurance company, and we’re happy to help review what information is available on our end.