This manuscript discusses how acupuncture has been incorporated into the twenty-first century US healthcare system. It traces the development of Chinese Medicine, and its uniquely localized variations in the US to date: Chinese Medicine in the US, Traditional Chinese Medicine, and American Chinese Medicine. I argue that Chinese Medicine has now entered a new stage, United States Chinese Medicine— where strictly, acupuncture’s definition in state regulation has affected its coverage under both private and federal health insurance to the detriment of patients and practitioners alike. The interaction of federal and state governments, regulatory boards, insurance companies, and acupuncture practitioners has created an unorganized framework across the country, effectively transforming it from being a unified “American” practice into an incongruous set of fifty. Through a lack of federal direction, separate state-specific acupuncture ecosystems emerge, in which practitioners follow available financial incentives to determine their state of choice. Through the non-consensus between governments, insurance providers, and practitioners concerning the purpose and practicality of acupuncture, insurance providers default to the biomedical healthcare paradigm’s standards to assign a monetary value to said component of alternative/complementary medicine. As a result, practitioners must not only be equipped with the skills of their medical profession, but also be prepared to identify their place in the medicolegal landscape, as to ascertain the profitability, legality, and direction of their business.