Yes. IRS Publication 502 states that you can include the amount you pay for acupuncture in medical expenses, which makes acupuncture an eligible expense for health savings accounts (HSAs) and health flexible spending accounts (FSAs). The timing matters more than the eligibility: FSA money is generally use-it-or-lose-it, so unused balances near year-end are worth planning around. Below we cover the IRS rules, HSA vs. FSA differences and the records to keep.
What the IRS says
Publication 502 is the IRS guide to medical and dental expenses. Its entry on acupuncture is short: you can include the amount you pay for acupuncture. Because HSA and FSA rules rely on the same definition of medical care, acupuncture sessions qualify.
What generally does not qualify: nutritional supplements, vitamins and herbal supplements, unless a medical practitioner recommends them as treatment for a specific medical condition diagnosed by a physician.
HSA vs. FSA: the key differences
| HSA | Health FSA | |
|---|---|---|
| Unused money at year-end | Generally carries over to the next year | Generally forfeited, unless the plan offers a carryover or grace period |
| Carryover | Not needed — the balance stays yours | Plan option; the maximum carryover was $660 for 2025 |
| 2026 contribution limit | Set separately for HSAs | $3,400 for plan years beginning in 2026 |
| Non-medical withdrawals | Taxed as income, plus a possible additional 20% tax | Reimbursements are for eligible medical expenses |
Source: IRS Publications 969 and 15-B.
Why November and December matter
If you have an FSA with a calendar-year plan, money you don’t spend by the deadline may be lost. Before the year ends:
- Check your balance with your plan administrator.
- Check your plan’s rules: does it offer a carryover, a grace period, or neither?
- Schedule appointments within the plan year, and ask your administrator whether it goes by the date of service or the date of payment.
How to pay and what to keep
- If your plan issued a payment card, ask whether it can be used at the front desk.
- If you pay out of pocket, submit an itemized receipt for reimbursement.
- Keep receipts showing the date, service (acupuncture), provider name and amount. Plan administrators can ask for them, and HSA owners are responsible for showing withdrawals were for qualified expenses.
Using HSA/FSA alongside insurance
If your health plan covers part of the visit, you can generally use HSA or FSA money for your share. If you have Medicare, note that it only covers acupuncture for chronic low back pain — see our guide, Does Medicare Cover Acupuncture?
The bottom line
Acupuncture is a qualified medical expense for HSAs and FSAs. If you have an FSA balance, check your plan’s deadline and carryover rules now. To book a visit, contact our Wexford clinic.
This article is general information, not tax or medical advice. Plan rules vary; confirm details with your plan administrator or a tax professional.