Acupuncture: HSA Eligibility

Acupuncture is an eligible expense when treatment is medically necessary. A benefits administrator may require a Letter of Medical Necessity (LMN) in order for the service to be eligible with a flexible spending account (FSA), health savings account (HSA) or health reimbursement arrangement (HRA). Acupuncture is not eligible for reimbursement with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is acupuncture?

Acupuncture is a medical technique that has deep roots in thousands of years of Asian medicine that concentrates on the body's patterns of energy flow, also known as Qi, disruptions of which are believed to cause disease. It is believed that this energy flows through meridians throughout the body, and it is theorized that acupuncture can correct imbalances in this energy flow at specific "acupoints" close to the skin to treat a wide variety of medical conditions.

During an acupuncture session, needles are inserted into specific acupoints on the body, and typically between one and 12 of these points will be used each time. They are inserted just under the skin, and may sometimes penetrate down to the muscle level depending on the condition being treated. The needles do not cause significant pain, and once they are in place, they will stay in this position for several minutes or even up to 30 minutes. In some cases, the acupuncturist may rotate the needles or stimulate them with a very mild electrical current based on the therapy needed to treat the medical condition.

What does acupuncture treat?

Acupuncture is primarily used as a form of pain relief, and while results may vary greatly between patients, promising results have emerged in the treatment of a number of specific medical conditions. For instance, acupuncture has proven effective in reducing nausea and vomiting from chemotherapy, as well as reducing discomfort from dental pain and the rehabilitative process following major surgery. It has also been known to relieve pain associated with fibromyalgia, osteoarthritis, labor pains, and muscle and joint injuries.

Acupuncture is eligible for FSA, HSA and HRA reimbursement if it is medically necessary, but many benefits administrators will require a Letter of Medical Necessity (LMN) from a physician. This letter must outline how acupuncture will be used to alleviate the issue and how long the treatment will last. If the treatment plan exceeds the current plan year, another LMN will have to be provided to the benefits administrator to cover the duration of the treatment.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)


Eligible with Rx

Eligible with LMN

Not Eligible

Specifically Not Covered

Acupuncture to promote general health, and not for the treatment of a medical condition, would not be eligible.

Legal Information / Regulations

Revenue Ruling 72-593


AZ-PROD-WEB02 4/25/2018 4:31:02 PM