Can You Use an FSA for Acupuncture?

A Flexible Spending Account (FSA) allows individuals to set aside pre-tax money from their paycheck for out-of-pocket healthcare costs. These tax-advantaged accounts cover various medical, dental, and vision expenses. Acupuncture can be eligible for FSA reimbursement when specific conditions are met.

Eligibility Requirements for Acupuncture

Acupuncture services qualify as an eligible expense for FSA reimbursement when they are for medical care. This means the treatment must be for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. Acupuncture used solely for general well-being or to maintain good health without a specific medical condition is not eligible.

For acupuncture to be considered medically necessary, a Letter of Medical Necessity (LMN) or a prescription from a licensed healthcare provider is often required. This document serves as certification that the service is recommended to treat a specific health condition. The LMN should outline the patient’s diagnosed medical condition, the specific acupuncture treatment needed, and the anticipated duration of the treatment. A licensed healthcare provider, such as a physician, chiropractor, or a licensed acupuncturist, can issue an LMN.

Essential Documentation for Claims

To substantiate an FSA claim for acupuncture, a Letter of Medical Necessity (LMN) or a prescription from a licensed healthcare provider confirms the medical necessity of the treatment. This letter should be kept on file and may need to be resubmitted annually if treatment extends over a longer period.

Itemized receipts from the acupuncturist are required. These receipts must include the date of service, the type of service provided, the amount charged, and the provider’s name and address. Generic charge receipts are not accepted.

If any portion of the acupuncture service was processed through your health insurance, an Explanation of Benefits (EOB) from the insurance carrier should be included. The EOB provides details on what the insurance covered and the remaining patient responsibility. If you paid out-of-pocket, proof of payment may be requested.

Submitting Your FSA Claim

Once you have received acupuncture services and gathered all necessary documentation, you can proceed with submitting your FSA claim. There are typically two main methods for accessing your FSA funds: using an FSA debit card or submitting a reimbursement claim. Each method has its own process and requirements for substantiation.

Using an FSA debit card allows for direct payment at the time of service, which can simplify the process. However, even with card use, you may still be required by your FSA administrator to submit documentation to substantiate the purchase. This is because the IRS mandates that all FSA expenses be verified for eligibility, and not all debit card transactions are automatically substantiated by merchants.

If you paid for the acupuncture out-of-pocket, you will need to submit a reimbursement claim. This usually involves accessing your FSA administrator’s online portal or completing a paper claim form. You will typically fill out fields such as the date of service, the provider’s name, and the amount of the expense. The required documentation, including the LMN and itemized receipts, must then be uploaded or attached to the claim.

After submission, claims are typically processed within a few business days, often ranging from two to five days. Reimbursement is commonly issued via direct deposit to your bank account, though some administrators may send a check. It is advisable to regularly check the status of your claim through your FSA portal and respond promptly to any requests for additional information to avoid delays.