Filling an acupuncture schedule before benefits reset

The first week of December is when an acupuncture clinic’s phone starts to sound different. Fewer callers describe a new pain. More of them are doing arithmetic: a flexible spending balance that has to go somewhere, a deductible finally met in October, and a feeling that all of it disappears on December 31.

For a shop that sells one appointment, that is a simple year-end push. An acupuncturist rarely sells one appointment. Treatment usually runs as a course over several weeks, and three weeks of December cannot hold a course, especially with the holiday closures at the end. The reminders you send this month have to be honest about that, or they fill the calendar with people who start a plan of care and stall in January.

What the IRS actually lets patients spend

IRS Publication 502, the list of what counts as a medical expense, is plain on this point: “You can include in medical expenses the amount you pay for acupuncture.” That single line is why a visit can be paid from a health FSA or an HSA, and in our experience a surprising number of patients have never been told. It belongs on your site, on the booking confirmation and in what the front desk says when someone asks about cost.

The year-end deadline belongs to flexible spending accounts. Publication 969 calls health FSAs generally “use-it-or-lose-it” plans, and an employer can soften that in one of two ways:

• A grace period that can run as long as two and a half months past the plan year’s end, which for a calendar-year plan means mid-March.
• A carryover, letting up to $660 of a 2025 balance roll forward, the cap set in Revenue Procedure 2024-40.

Some employers offer neither, and the balance is simply forfeited. Your clinic cannot see which of those a patient’s employer picked, so a December message should send people to check their own plan rather than tell them what they are about to lose.

Why a course of treatment changes the message

Picture a new patient who books for December 8 and comes twice a week. Before most clinics close for the holidays, that patient fits perhaps five visits. What happens next depends on the plan:

1. Grace period plan. The remaining visits can run through February and into March on the same balance, so book them now while there is choice of times.
2. Carryover plan. Part of the balance follows the patient into the new year, so the course continues without a gap.
3. Neither. Book what genuinely fits before December 31, and plan the rest against next year’s election, which many employees are making right now.

Lead with the plan of care, not with the balance. “Here is how we would schedule your course around the holidays” earns more trust than “spend it before you lose it”, and it keeps the conversation clinical rather than promotional.

Keep the condition claims out of these emails too. California’s acupuncture board says it is improper for an acupuncturist to disseminate advertising that represents they can cure any disease, condition or symptom, and a year-end reminder to your list is still advertising. Name the times you have open and what a visit involves, and leave outcomes alone.

Insurance adds a second check. NCCIH reports that the share of adult visits to acupuncturists with any insurance coverage rose from 41.1% in 2010 to 2011 to 50.2% in 2018 to 2019, and it notes that coverage is often limited by the condition being treated. A patient who has met their deductible may still have a plan that covers acupuncture for one complaint and not another, so the front desk confirms coverage for the reason they are coming in before anyone says the word “covered.”

Medicare patients follow a different clock

Medicare has covered acupuncture since January 2020, but only for chronic low back pain lasting 12 weeks or longer. It pays for up to 12 treatments in 90 days, 8 more if the patient shows improvement, and no more than 20 in a 12-month period; once the Part B deductible is met, the patient owes 20% of what Medicare approves. Medicare.gov is direct about the rest: Medicare cannot pay licensed acupuncturists directly.

Two consequences for a December campaign:

• A clinic where only licensed acupuncturists treat should leave Medicare out of its year-end benefits message entirely. Some older patients will read “use your benefits” as including Medicare, and the call that follows ends in disappointment.
• An integrative clinic with a physician, physician assistant or nurse practitioner billing can serve these patients, but the cap runs by 12-month period and by the patient’s own course, so it does not line up neatly with a December deadline. Schedule those patients on their clinical timeline, not the calendar’s.

January, and the patients who wait for it

As soon as the holidays end, the pressure flips. Deductibles start over on many plans, so insured patients carry more of the cost of their first visits and some pause treatment until spring. At the same time, new-year health goals bring first-timers who have never had acupuncture and are searching “acupuncture near me” on their phones.

Both groups land on your profile before they land on your site. If your Google Business Profile still shows regular hours over the holiday closure, the first-timer finds a locked door, and the returning patient assumes you are closed for longer than you are. Holiday hours, current photos of the treatment rooms and a recent reply on every review do more in the first week of January than any ad.

One more job may land in January. The national certifying body, NCCAOM, took public comment from May 15 to June 5 this year on a proposal to change its name. If the change goes ahead, every bio, credential badge and directory listing that uses the old name will need updating, and it goes faster as one sitting with a list than as a string of fixes whenever someone notices.

What to do this month

• Before December 12, email active patients and anyone who left a course unfinished this year. Ask them to look up what remains in their FSA and when their employer’s plan closes, and list the times you have open. No cure language, and no Medicare line unless a physician, PA or NP bills at your clinic.
• Add a sentence to your site and booking confirmations saying the IRS lists acupuncture as a medical expense, payable from an FSA or HSA where the plan allows.
• Set holiday hours on your Business Profile today, including every day you close.
• Tag each patient who mentions a grace period, and schedule a reminder for mid-February while you still remember who they are.
• Write a short page explaining how insurance, deductibles and self-pay work at your clinic, ready to link from the first January email.

A clinic that gets December right walks into January with courses already booked through the grace period and a list of who to call when deductibles bite. Keeping that list, and sending the right note to the right patient without anyone remembering to, is the job we give GoHighLevel in an acupuncture practice. Our page for acupuncture clinics covers the other half: credentials, reviews and how new patients find you.