Naturopathic Medicine Is Growing Fast—Here's What You Need to Know About Licensing and Coverage

Naturopathic medicine has experienced explosive growth, with usage among US adults increasing from 0.2% in 2002 to 1.3% in 2022. The profession itself more than doubled from approximately 2,000 licensed practitioners in North America in 2000 to an estimated 5,000 licensed practitioners in the United States and more than 2,000 in Canada by 2016. But with this growth comes confusion about who's actually qualified to practice and what insurance will cover.

What's the Difference Between Licensed and Unlicensed Practitioners?

Not all naturopathic practitioners are created equal. There are three main types of naturopathic practitioners, and the differences matter for your safety and wallet. Licensed naturopathic physicians complete graduate-level education at a naturopathic medical school accredited by the Council on Naturopathic Medical Education, followed by passing the rigorous Naturopathic Physicians Licensing Examinations (NPLEX).

Traditional naturopaths, also known simply as "naturopaths," may receive training through various non-accredited programs that vary widely in length and content. These practitioners are not eligible for licensing. The distinction is crucial: licensed naturopathic doctors complete a minimum of 4,100 hours of class and clinical training at accredited medical schools, including more than 1,200 hours of hands-on, supervised clinical training.

Which States Actually License Naturopathic Doctors?

Currently, 26 US jurisdictions offer naturopathic licensure or certification, including the District of Columbia, Puerto Rico, and the US Virgin Islands. In Canada, six provinces and one territory regulate naturopathic doctors. The licensed states include:

• Western States: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, New Mexico, North Dakota, Oregon, Utah, Washington, and Wisconsin
• Eastern States: Connecticut, Maine, Maryland, Massachusetts, New Hampshire, Pennsylvania, Rhode Island, and Vermont
• Other Jurisdictions: District of Columbia, Kansas, Minnesota, Puerto Rico, and US Virgin Islands

Licensing requirements vary significantly across jurisdictions. To become licensed, practitioners must graduate from a four-year naturopathic medical college, pass national board exams, complete jurisprudence examinations, meet background check requirements, and fulfill continuing education requirements.

What About Insurance Coverage and Prescribing Rights?

Insurance coverage for naturopathic medicine remains limited but is expanding. As of 2022, more than half of states that license naturopathic doctors allow for some degree of prescribing, though the scope varies by state. Licensed naturopathic doctors can order blood tests, X-rays, and magnetic resonance imaging (MRIs), and in some states, prescribe medicine and perform minor surgeries and in-office procedures.

Medicare coverage is extremely limited, covering acupuncture only for chronic low back pain lasting 12 weeks or longer with no known cause. Patients can receive up to 12 treatments in 90 days, and if improvement is shown, an additional 8 sessions for a maximum of 20 treatments in a 12-month period. Medicaid coverage varies by state, with six states covering Medicaid for naturopathic doctors as of 2022.

The regulatory landscape creates both opportunities and challenges. "Licensing offers protection to the public and a guarantee that the provider has met educational standards and continuing education requirements," according to the Association of Accredited Naturopathic Medical Colleges. It also "increases access to, and provides a pathway for established and regulated care" while providing "oversight and recourse for patient claims and medical malpractice."

For patients considering naturopathic care, understanding these distinctions is essential for making informed healthcare decisions and choosing the provider best suited to your needs. Always verify your practitioner's credentials and check with your insurance provider about coverage before beginning treatment.