Medicare coverage for pain management: What you should know

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Living with pain isn’t something you should have to accept as you get older. The good news? Through your Medicare Part B, you may have options to help offer relief without breaking the bank.

Many people don’t realize just how many pain management options Medicare covers. Medicare offers several ways to help manage chronic pain (lasting three months or longer).

Let’s look at some of what’s available to help.

What Medicare covers

Acupuncture

If you have chronic low back pain that’s lasted at least 12 weeks, Medicare will cover up to 12 acupuncture visits in a 90-day period. If you’re showing improvement, you can get up to eight more sessions. That’s a maximum of 20 treatments each year.

Medicare only covers acupuncture when it’s provided by a doctor, nurse practitioner, or physician assistant who is qualified to perform it. It also does not cover acupuncture for other diagnoses.

Chiropractic care

Medicare covers manual manipulation of your spine if it’s deemed medically necessary to correct a subluxation (when one or more bones of your spine move out of position). Your chiropractor must document the subluxation for Medicare to pay for treatment.

Please note that Medicare won’t pay for other services from chiropractors, like:

Massage therapy
X-rays ordered by a chiropractor

Acupuncture performed by a chiropractor
Maintenance therapy after your condition improves

Massage therapy
X-rays ordered by a chiropractor
Acupuncture performed by a chiropractor
Maintenance therapy after your condition improves

Physical and occupational therapy

Physical therapy focuses on movement and function, while occupational therapy centers on helping you perform daily activities despite pain or limitations.

These therapies can be extremely helpful for managing pain and improving your ability to do daily activities. Medicare covers these services when ordered by your doctor and provided by qualified professionals.

Mental health services

The overlap between pain and mood is clear, so if someone is in pain, their mood can suffer. Fortunately, Medicare provides some protection for pain that’s impacting your mental health.

Depression screening: You get one free depression screening each year.
Alcohol misuse screening & counseling: If you’re using alcohol to cope with pain, Medicare covers screening and up to four brief counseling sessions per year if your doctor determines you’re misusing alcohol.
Opioid use disorder treatment: Medicare covers services provided by special Opioid Treatment Programs, including medication (like methadone), counseling, drug testing, and individual/group therapy.
Behavioral health integration: This benefit helps your primary care doctor work with mental health specialists to treat conditions like depression or anxiety that may be making your pain worse.

Monthly chronic pain management

Medicare now covers monthly services specifically for people with chronic pain (pain that lasts three months or longer). This newer benefit includes:

Regular pain assessments
Creating and updating care plans
Medication management
Coordination between your health care providers

This benefit can help you get consistent, ongoing support for managing chronic pain.

Your possible out-of-pocket 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. That said, Part B covers 100% of the cost for some (like depression screening and alcohol screening and counseling). Your yearly Part B deductible ($257 for 2025) applies.

Other considerations on out-of-pocket costs

If you have a Medicare Supplement insurance plan, your policy covers the remaining 20% of the Medicare-approved amount for the covered service and if your provider accepts Medicare.
If you receive treatment in a hospital outpatient department, you might have additional facility fees on top of the 20% coinsurance.

Medication coverage

Medicare prescription drug plans (Part D) may cover medications for pain management. Each plan has its own list of covered drugs (called a formulary), so check your plan’s details.

Some plans offer Medication Therapy Management programs for people with complex health needs or multiple medications. These programs can be helpful for medication reviews, and open communication between you, your doctors and the pharmacist to help approach your needs from a holistic perspective.

What may not be covered

Please be aware that not all services are covered by Medicare, so it’s important to make sure you have coverage in place before accessing them. Some examples of services that may not be covered by Medicare include …

Most acupuncture (except for chronic low back pain)
Certain types of counseling
Some alternative medicine approaches

Before paying out-of-pocket for these services, make sure you’re taking full advantage of the pain management services Medicare does cover.

Talk with your doctor

The best approach to managing your pain will depend on your specific situation. But if there’s one thing you should keep in mind, it’s this — don’t suffer in silence. Bring up your pain during doctor visits and find out what approaches may be helpful in improving how you feel, and if they’re covered by Medicare.

With the right combination of treatments and services, many people find significant relief from pain, even if it can’t be eliminated completely.