Frequently Asked Questions
"Do y'all take insurance?"
It's a question we get asked frequently, and it's most certainly a good one. Many insurance companies are beginning to cover acupuncture treatment for certain diagnoses, and yours may be one of those plans. In most cances, unfortunately, reimbursement by those insurance companies just isn't feasible ffor small offices and single practictioners like us for right now. We hope that that will change in the future as acupuncture becomes a more accepted treatment modality. However, that doesn't mean you can't use your insurance to help pay for the cost of your visits with us. What we can do while we're working on getting to a place where we can accept insurance is to provide you with something called a superbill. It's an itemized bill that has all of the information that we would submit on a claim (our tax ID number and NPI, and the diagnosis and procedure codes for your visit) that we print for you, and then you can forward that information on to your insurance carrier for reimbursement. It's likely that your insurance carrier has a form or two that they'll want you to submit, and it will likely be an out-of-network benefit, meaning the co-pay, co-insurance, and amount reimbursed will be different compared to what it would be if we were in-network for your plan. We're happy to try to help you through that process as much as we can. It's also worth knowing that even if we can't file a claim to your insurance company to cover your visit, acupuncture is considered a qualified medical expense, which means you can use your FSA (flexible spending account) or your HSA (health savings account) to pay for your visit.
Related: I have chronic low back pain and Medicare just started covering acupuncture for that. Can I use my Medicare Part B to pay for my visits?
It's a similar answer, for some different reasons. When Medicare opted to start covering acupuncture to treat chronic low back pain, there was little discussion or direction on how Licensed Acupuncturists would end up being able to bill Medicare for their services. With the way Medicare works, only certain provider types that are defined in the Social Security Act are permitted to file claims for Medicare reimbursement. Licensed Acupuncturists aren't one of those specialties right now. However, our state professional association has recently been made aware that the verbiage of the rules that allow Medicare to cover acupuncture does include services provided by Licensed Acupuncturists. It's a weird situation for us - Medicare tells us we're able to provide acupuncture services for its members, but we aren't allowed to bill Medicare directly for those services. A conundrum. It's recently come to light that the process for patient-requested reimbursement may be the answer, although it's not a fun one. Similar to the insurance question previously, we've been told that we can provide you with a superbill that has all of the necessary information, and then you can file a 1490S Patient's Request for Medical Payment form (find the form on the Centers for Medicare and Medicaid Services here) requesting reimbursement. It's our understanding that if filled out and submitted correctly and you qualify for acupuncture coverage for your chronic low back pain, that process should get you the same reimbursement as if we were able to file the claim for you. It's important to remember that right now, Medicare covers acupuncture ONLY for chronic low back pain (lasting 12 weeks or longer) that has no known cause and is not associated with surgery or pregnancy. More info on coverage here.
Also Related: Does Medicaid cover acupuncture?
As far as we know, Kentucky Medicaid doesn't yet cover acupuncture. However, it's always worth calling your MCO to double check that, as there may be some MCOs that have an add-on benefit that does include some coverage. Please keep in mind that individual MCOs may require that you use an acupuncturist who is either in-network or credentialed with them, that we would not fall into that category at this time. They should, hopefully, have a list of providers you can see that they can provide you.
"Does acupuncture hurt?"
The short answer is no, it shouldn't. That doesn't mean that you won't feel anything at all, though. We do look for certain sensations to make sure that we're getting things in the right place to do the most for you that we possibly can. Sensations that are common and are a good sign are things like heaviness, dull achiness around the needle, or a quick and very short-lived jolt of electricity down a limb. Things that we don't want you to experience are stabbing or severe pain, a constant shot of electricity down a limb (again, a quick jolt that goes away as soon as you feel it is a good sign, but lasting electrical shocks are not okay), faintness or dizziness, or anything that is too much for you to feel okay with, even if it's on the good sensations list. In the end, we want you to be as comfortable as possible for the duration of your treatment. Similarly, cupping and gua sha can be a bit intense, but it should not be painful. If you're ever not sure about what you're feeling, please let us know so we can adjust things for you.
"How long will my visit last?"
It depends! Your first visit usually lasts a little bit longer than subsequent visits, depending on how chatty of a person you are or how involved your symptoms are. If you're having a lot of related symptoms that we need to go through, say for painful and irregular periods, your intake will take longer than if you have a straightforward complaint, like musculoskeletal pain after overexerting yourself at the gym. Typically, your first visit for acupuncture will take about an hour to an hour and a half, and visits after that will take about an hour. If we're also doing cupping or gua sha, along with acupuncture, that will add 15 to 30 minutes to your visit. And if you're coming in just for cupping or gua sha, plan about 45 minutes-ish in total for intake and treatment.
"What kind of training do you have to have to be a licensed acupuncturist in Kentucky?"
Licensure for acupuncturists in Kentucky is administrated by the Kentucky Board of Medical Licensure (KBML) - this is the same licensing board that issues licenses for physicians (both MDs and DOs), physician and surgical assistants, genetic counselors, and athletic trainers. The requirements for a license to practice acupuncture in the commonwealth include graduation from an accredited program that includes at least 1800 total hours, 300 of which must be clinical, and passing a national board exam (which is actually three exams administered by the National Commission for Certification of Acupuncture and Oriental Medicine and one exam administered by the Council of Colleges of Acupuncture and Oriental Medicine). There are, of course, some other paths for acupuncturists who have been licensed in other states. In addition, we have to renew our licenses every two years, a process which also requires at least 30 hours of continuing education.
Please note that these requirements are for licensed acupuncturists only. "Dry needling," also called "trigger point acupuncture" and "trigger point dry needling," is a practice that is far less regulated in Kentucky, and does not have such stringent requirements. The practice of trigger point dry needling is a therapy that is already part of the scope of practice for acupuncturists, but the state allows some other practitioners (doctors and physical therapists come to mind, and maybe also chiropractors) to learn how to deliver this modality but does not have any requirements on what kind of training program these practitioners have to go through in order to offer the service. This means that a PT can go to a weekend seminar and spend 16 hours in a classroom talking about it, and then go back to their office and start practicing dry needling on their patients without any clinical experience, competency exams, additional licensure processes, additional malpractice coverage, clean needle and other safety training, or continuing education.
"How safe is acupuncture?"
When acupuncture is administered by a fully trained, board-certified, licensed acupuncturist, it's very safe. We use only single-use pre-sterilized solid filiform acupuncture needles (meaning they're used once and discarded rather than being sterilized and reused, and they're extra thin and solid so they're super flexible), and we are trained to know not only where to place the needles, but how deeply and at what angle we can insert them safely. Our board certification includes an exam administered by the Council of Colleges of Acupuncture and Oriental Medicine, the CNT or Clean Needle Technique exam. This exam makes sure that we're trained in the most effective infection control practices, including but not limited to proper hand washing, proper handling of used and unused needles, proper cleaning and disinfection of reusable medical devices like cups and gua sha boards, and how to properly use PPE or Personal Protective Equipment like masks and gloves. That said, like every medical intervention, there are risks associated with acupuncture. Most commonly, adverse events (risks) include bruising and minor bleeding. More major risks include puncture of arteries and organs which can lead to serious problems like infection or pneumothorax ("collapsed lung"). However, instances of scary things like that are exceptionally rare. If you have an allergy to silicone, latex, or metals like nickel, please be sure to let us know so that we can choose the right needles and PPE to use during your treatment.
"How often do I have to get acupuncture for it to work?"
My favorite answer: it depends! If you're coming in for a recent round of back pain after picking up something a little too heavy and not putting it down quickly enough while you were at the gym, it might only take a couple of visits over a handful of days to knock that pain out and get you back to normal. If you've been dealing with chronic pain for years and years, and only recently learned that acupuncture could be a good fit for you (or only recently decided that the pain has gotten bad enough to give it a try), it may take a while before you can see lasting results. For cases like this, we tend to recommend weekly treatments for a few weeks, and then start to scale back to once every other week for a month or two, then to once every three or four weeks after that for maintenance. We also completely understand that finances are tight for a lot of people right now, and that may be asking too much. Coming once a month to start is absolutely better than not coming at all - but that does mean that it will take a bit longer to see lasting relief. We may only be able to get you a couple of great days immediately following treatment before things start getting back to the not-so-comfortable normal, but the longer you can stick with it, the longer those periods of relief should be lasting. We'll check in with you at each visit to track your progress, and we always adjust treatment plans if we're not getting the results you'd like to see. And if you decide after a couple of months of trying that acupuncture isn't for you and you'd like to stop coming, that's totally okay too. You're in charge of your health. We'll certainly miss you, but we'll completely understand and support your decision.
"Is there anyone who can't get acupuncture?"
The short answer is no, acupuncture is safe for everyone as long as it's administered by a licensed and well-trained acupuncturist. However, as with any new therapy, it's a good idea to check with your primary care provider prior to starting acupuncture if you have any serious conditions that make you think it may not be safe for you. There are some acupuncture points that are contraindicated during pregnancy, but we're trained to avoid those while treating patients who are pregnant - make sure you let us know if you're expecting! We also need to know if you have any serious health concerns and what kind of medications and dietary supplements you're taking, since some medications and supplements can increase the risk of bleeding or clotting. All of these things are part of our regular intake when you start seeing us, so make sure you let us know about things like that, whether it's your first visit with us or if something changes after you've been seeing us for a while.
"Is acupuncture the only treatment you provide?"
Not at all! Acupuncture is only one modality in the realm of Traditional Chinese Medicine, and while it's one of the most easily recognizable or popular of our therapies, it's certainly not the only one. Cupping is also a popular (and super effective!) modality that's most commonly used for musculoskeletal issues, but can also be used for other conditions like the common cold, headaches, and even some digestive problems! We also do Guasha, which is a scraping technique that's similar to cupping, but allows us to get into areas like the neck, which are more difficult to reach with cups. Tuina is another less-known modality that is a type of body work, sort of like massage but with very different techniques. Qi Gong is a practice that's sort of like an energetic version of physical therapy - we use certain movements and breathing techniques to affect the way we feel and how our bodies work. Reflexology is another option, a massage technique that's used on the feet to affect change throughout the body via nerve pathways and energetic pathways. We also offer dietary counseling based on Traditional Chinese Medicine principles and breathwork coaching.
"My grandma got acupuncture once for her headaches and never had another one as long as she lived! How do I get that kind of magical treatment?"
That's amazing for your grandma, and I'm so glad she had that experience! We all seem to be fascinated by the idea of a quick and easy fix, but it's honestly not a common outcome for any medical specialty, including acupuncture and Traditional Chinese Medicine. That's not to say it can't happen, but it's certainly not something we can guarantee and it honestly isn't something that you should go into your first treatment expecting. Like with prescription medications, physical therapy, and diet and lifestyle changes, acupuncture works best with consistency over time. We very well may get you some awesome relief after your first visit, but it's entirely possible that either doesn't happen and you only feel a little bit better after your first visit, or you feel super fantastic after your first visit but then start feeling the same a couple of days later. Both of these experiences are common, and don't at all mean that your acupuncture didn't really work. For most people, it takes frequent treatments in the beginning that eventually scale back to whatever frequency your body needs to feel your best for as long as possible. Think of it like coming in for "tune ups" at regular intervals. For some, this may be once a month. For others, maybe once a week. And others may only need to come in every two or three months when the seasons change and they start feeling icky again. The bottom line is that there is no magic pill or magic treatment that's a one-and-done kind of deal for any ailment. Anyone who tells you they can fix whatever ails you with one pill, one treatment, one session, or one easy payment of $59.99 probably isn't being entirely truthful. We do promise you that if you don't see the results you'd like to see or if we do everything we can and we don't see the results we'd expect to see, we will absolutely refer you out and encourage you to get a second opinion.
"Are you a doctor?"
No. Some acupuncturists have masters degrees, like ours does, and others may have a DAOM - a doctorate degree in acupuncture and East Asian medicine. These practitioners can be referred to as "doctor," in the same sense that a PhD is a doctor and a DC (chiropractor) is a doctor, but aren't physicians like a Medical Doctor (MD) or Doctor of Osteopathy (DO). DAOMs and L.Ac.s are both considered "allied health" practitioners in Kentucky, like physician assistants, surgical assistants, and genetic counselors. But don't let that technicality fool you - we are absolutely medical professionals!
"What is 'complementary and alternative' medicine?"
These two terms are often lumped together, but there's actually a bit of a difference in approach. When you go to the hospital and see a doctor there, or you go to your family doctor and see your primary care provider, either an MD/DO or a nurse practitioner, you're most likely being treated with an allopathic medicine approach. This is what we typically think of when we talk about Western medicine. This simply means that you're being treated with an approach where medications or treatments are used that are incompatible with the symptoms of the disease you're being treated with. This is a reactive approach - something becomes wrong in how your body is functioning, so allopathic medicine is employed to "fix" it. Functionally, allopathic medicine typically looks at the human body as a collection of separate systems. If something is wrong with your digestive processes, you're likely to see a gastroenterologist who specializes in treating digestive disorders. If something is wrong with your heart, you're most certainly going to see a cardiologist, who specializes in treating heart conditions. Family doctors are often internal medicine doctors, who do technically treat pretty much anything that can go wrong with the human body, but they're still trained to see the body as a system of smaller systems that work together. Acupuncture and Traditional Chinese Medicine is a holistic practice - we always look at the human body as a single large system. This includes not only physiological processes like digestion and circulation of blood, but also the psychological and energetic systems. Energetic systems are not something that exist in allopathic medicine, and this is where that "complementary and alternative" thing can get a bit messy sometimes. To be clear - the term "complementary and alternative" often carries a connotation that TCM is not a self-sufficient or complete medical system, and that's absolutely not the case.
We define our approach as an integrative one. We don't want to replace your primary care provider and all of your prescription medications, and we certainly aren't going to try to make you think you don't need either of those. As an integrative practitioner, our role is sort of filling in the gaps in where allopathic medicine isn't always the best answer or doesn't always work as well as you'd like it to. For example, if you're a patient who has low back pain, your first stop should always be your primary care doctor. They'll likely order x-rays, maybe an MRI, and rule out any serious issues like a herniated disc or, worse, a tumor. Maybe they find that you've got a bit of a bulge at L5-S1, but it's not severe enough yet to require surgery to correct. Several years ago, you likely would have been sent home with a prescription for a narcotic pain medication and instructions to take it easy on the lifting of heavy things. In recent years, though (thankfully!), that prescription is more likely to be for physical therapy and a non-narcotic painkiller, maybe an anti-inflammatory drug. The answer for allopathic medicine, though, is still medication. As an integrative medicine practitioner, we'd love for you to go to that physical therapist and take that anti-inflammatory drug if you feel like you need it (or want it). But all drugs have side effects, and we'd also love for you to come have acupuncture a couple of times a week right after your injury so that we can try to either get you enough pain relief that you only have to take your pain medication after you accidentally pick up something a little too heavy and make your back cranky again, or to get you enough pain relief that you don't have to take the pain medication even after your physical therapist is extra tough and has you doing all of the hard things. We complement. Best case scenario, you get to a point where you come see us once a month and never have to have that surgery, because of a combination of that Western allopathic based physical therapy and the integrative East Asian medicine we were able to provide to you.
Alternative medicine is a little different, in that the aim there is to replace allopathic medical interventions entirely. Frequently, specialties like naturopathy or maybe a Doctor of Acupuncture and East Asian Medicine who also practices herbal medicine, are the most likely to take an alternative approach rather than an integrative one. Objectively, there's nothing wrong with this approach when it's employed carefully and thoughtfully. The best scenario I can think of is that a healthy person with no medical conditions whatsoever wants to stay healthy but avoid any of the side effects that come along with pharmaceutical medications, so they opt to see a provider who is a DAOM and also a licensed naturopath who prescribes herbs and homeopathic remedies to prevent illness during cold and flu season. It's important to note, though, that both herbs and homeopathic remedies (as well as essential oils, flower essences, and the like) all have the potential for side effects just like pharmaceutical medications. We just tend to think they're less risky because they're marketed as "natural" and "non-pharmaceutical" remedies.
"My doctor says acupuncture doesn't really work and it's just the placebo effect if anyone sees any relief. I looked on Wikipedia and it classifies acupuncture as pseudoscience. Why should I keep seeing you?"
Okay, so this is a lot to unpack. Buckle in.
For the first part of the question, a lot of allopathic doctors haven't really had the exposure to or done any research on acupuncture and other traditional and indigenous medicine practices. Many times, allopathic physicians have gotten into the mindset that any other type of medicine is unscientific and, at best, "only" the placebo effect. Complementary and alternative practices, and even integrative practices, many of which are traditional and indigenous healing arts, typically have a harder time passing muster in the western paradigm that requires rigorous testing that is randomized and double-blinded for control. This is because they tend to rely more heavily on the personal involvement of the practitioner. Allopathic physicians walk into the room, ask you some questions, run some tests where the outcome of "normal" or "abnormal" is determined by a system of averages, and then prescribe the medication that has been shown in randomized and controlled double-blinded studies to be effective for most people. It doesn't matter how you feel about your practitioner or how your practitioner feels about you - if the tests that are run determine that you have illness A, you are then prescribed the medications that have been shown in controlled studies to treat illness A. It's extra hard for a practice like acupuncture, that relies on a physical intervention by the practitioner, to be randomized and double-blinded for control. If you have any idea what acupuncture is, you're going to know if your practitioner is sticking needles into you for this study for which you've volunteered. When it comes to herbal medicine, it's a bit easier to meet those randomized and double-blinded requirements, but still a challenge, considering herbal prescriptions are tailored to the individual - you may be seeing an herbalist for indigestion just like your twin sibling, but their symptoms are slightly different and therefore their herbal prescription is slightly different to account for the symptoms. Holistic medical practices like acupuncture and Traditional Chinese Medicine don't do well in Western scientific studies because the scientific method requires a level of standardization that is directly oppositional to the art of the medicine. Researchers are getting better at designing studies that can better demonstrate benefit, but it's still apples and oranges.
Where the placebo effect is concerned, it's never "just" the placebo effect. This refers to a phenomenon where benefit is seen when a placebo drug or treatment is administered - the drug or treatment has no innate therapeutical properties, and yet somehow the person receiving the placebo still gets better (or worse). Allopathic medicine and scientific researchers write this off as an anomaly, a weird thing that sometimes happens that can't be explained. Interestingly, in some studies, these outcomes are discounted and removed from the data completely so that they won't affect the outcome of the study. There was an interesting article about it in Psychology Today (read it here). When it really comes down to it, the ability of science to explain how something works and the ability of researchers or practitioners to understand exactly how a treatment works (its mechanism of action) doesn't matter. Treatments don't work if the body (or brain) don't want them to. Drugs don't heal people. Treatments don't heal people. Doctors and nurses and acupuncturists don't heal people. Bodies heal themselves. Drugs, treatments, and practitioners help create an environment, whether internal or external, that allows the body to better heal itself more quickly. Check out any pharmacology text book and thumb through for the explanations for a lot of the drugs we know to treat specific diseases. In a lot of cases, that book will say "exact mechanism of action is unknown, but studies have shown..." or something along those lines.
Where Wikipedia is concerned, this is a symptom of the greater problem we have in the West where the Western way of doing things is the default and everything else is suspect. Call it white washing, call it bias, call it xenophobia, call it whatever you want. Because it's more difficult to "prove" in a scientific setting that is not designed with the principles of Traditional Chinese Medicine in mind, acupuncture must be pseudoscience. Like your physician, because randomized and double-blinded clinical studies have a hard time controlling for the importance of practitioner involvement and individualization of treatment, the editors at Wikipedia have decided that it must be a bunch of quackery. Traditional Chinese Medicine and its practice of acupuncture wasn't developed in the same culture or foundational observations that allopathic medicine was. Expecting acupuncture and TCM and other traditional and indigenous healing arts to be able to be "proven" or "disproven" using the principles developed under a Western paradigm alone is... well... a lot of adjectives come to mind, but let's go with self-centered and generally not a well-informed practice. And while anecdotal evidence may not carry as much weight as "real science" under the Western medical paradigm, it's still evidence (and there's an awful lot of it where traditional and indigenous healing arts are concerned for it to just be ignored because it's anecdotal). Side note: I'd like to take this opportunity to pass along what the school librarian was careful to remind us of while I was in acupuncture school: Wikipedia is not a scholarly resource. It's not an encyclopedia. It's not a peer-reviewed journal. It's a website that acts as a clearing house of both verified information and opinion with moderators that decide what information stays and what information goes, without any guarantee that hey have any sort of background that would qualify them to make the decisions they make. Acupuncturists have been trying for decades to submit corrections and link clinical studies that demonstrate the efficacy of acupuncture as real medicine, and have been silenced and had their corrections reversed for decades. I'm sure those moderators are super nice people, though.
As to whether or not you should continue coming in for acupuncture... You are in charge of your health. It's ultimately your decision to continue coming for acupuncture or not. You're allowed to make decisions on what kind of treatments you want to pursue in every aspect of your health journey, be it declining to have that surgery to fix your L5-S1 disc herniation, opting to go ahead with that breast augmentation surgery because it might just help you feel happier in your body, or choosing to take narcotic painkillers for the rest of your life rather than having an acupuncturist work on you once a month. You, and you alone, are the author of your story. Don't let any doctor, web site, or acupuncturist tell you otherwise (but do please keep in mind that we all are trained to help you make the best decisions possible, and that we do honestly care about your outcomes being as fantastic as they possibly can be!).