The only chiropractic service that is covered by Medicare is manual manipulation for subluxation of the spine. That is when one or more of the bones of your spine move out of position when provided by a chiropractor or other qualified provider.
HOW MUCH DOES MEDICARE PAY FOR CHIROPRACTIC SERVICES?
- Medicare part B covers chiropractic services under specific condition.
- Coverage applies only if chiropractic care is medically necessary to correct a subluxation.
- Medicare pays 80% of the approved amount chiropractic adjustment.
- patients are responsible for the remaining 20% of the cost.
Part’s of Medicare
There are 4 part’s of Medicare that are A B C and D. Each Medicare part covers different aspect of Medicare. 1.PART A – Helps for inpatient hospital care. If you need to go to a rehabilitation facility after a hospital stay or need certain home services to help you recover from illness, these services are covered under part A. So is hospice care. 2.PART B – It covers outpatient services. when you need to go to the doctor, get an X-ray or other diagnostic test need a wheel chair or other piece of Medicare equipment, or need outpatient for therapy, those services are covered under part B. Some home health care that part A does not cover is also included under Medicare part B. 3.PART C – Commonly known as Medicare advantage, is the private insurance alternative to original Medicare. If you join a Medicare advantage plan, you’ll get all the services you are entitled to under part A and B, and probably will also get coverage for prescription drugs. 4.PART D – Is another private insurance aspect of Medicare.
What’s Covered:
- Spinal Manipulation: Medicare Part B covers chiropractic care that includes spinal manipulation, but it must be medically necessary to treat a specific spinal condition, typically a subluxation (misalignment of the spine). These treatments are only covered if they are used to alleviate pain or restore function.
What’s Not Covered:
- Other Chiropractic Services: Medicare does not cover other chiropractic services like:
- X-rays or imaging (unless specifically required for the spinal manipulation)
- Nutritional advice
- Massage therapy
- Exercises or physical therapy
- Long-term or maintenance treatments
Requirements for Coverage:
- The chiropractor must be enrolled in Medicare and accept assignment (agreeing to Medicare’s approved payment amounts).
- Chiropractic care is typically covered for the duration of treatment for a medically necessary condition, but not for routine, ongoing care.
If you’re considering chiropractic care under Medicare, it’s a good idea to verify the specifics with your provider and confirm the services are covered under your plan.
Conditions a chiropractor can treat
Although chiropractic treatment may be effective for relieving specific pains, some chiropractors have made unsubstantiated claims about the benefits of the practice for nonmusculoskeletal conditions. However, a 2016 articleTrusted Source set out a list of ways to improve the scientific standing of this technique.
Most chiropractors have since abandoned the idea that spinal manipulation can help treat conditions with no link to the spine.
Still, chiropractic care serves as an alternative to other treatment options for pain and discomfort, such as surgery or pain medications.
Some conditions a chiropractor can treat include the following:
- back pain
- conditions affecting the joints, ligaments, and muscles
- headaches
- neck pain
In addition to these services, a chiropractor may offer wellness services, which can include diet, exercise, and nutrition interventions
Summary
Medicare Part B covers chiropractic manipulation of the spine to correct a vertebral subluxation, which may cause back pain. However, it does not cover chiropractic care for other reasons.
Other back pain therapies Medicare may cover in certain circumstances include acupuncture and physical therapy.
