Medicare coverage of chiropractic service is specifically limited to treatment by means of manual manipulation of the spine to correct a subluxation (that is, by use of the hands). The patient must require treatment by means of manual manipulation of the spine to correct a subluxation and the manipulative services rendered must have a direct therapeutic relationship to the patient's condition and provide reasonable expectation of recovery or improvement of function. Additionally, manual devices (that is, those that are hand-held with the thrust of the force of the device being controlled manually) may be used by chiropractors in performing manual manipulation of the spine. However, no extra payment is available for use of the device, nor does Medicare recognize an additional charge for the device itself.
Access the below chiropractic services related information from this page.
- Claim Submission Requirements
- Documentation Guidelines
- Excluded Chiropractic Services
- General Coverage and Subluxation
- Related Latest Updates Articles
A Beneficiary is responsibility for these services. A provider may bill patient without billing Medicare.
- Dietary advice/nutritional supplements
- Lab or other diagnostic tests
- Physical therapies (exercise, ultrasound, traction)
- Office visits
- Supplies (pillows or vitamins)
- Supportive (bracing, orthopedic)
- CMS Internet Only Manual (IOM), Publication 100-01, Medicare General Information, Eligibility, and Entitlement, Chapter 5, Section 70.6 - Chiropractor by Definition
- CMS IOM, Publication 100-02, Medicare Benefit Policy Manual Chapter 15, Section 24.0 and 30.5 - Chiropractic Services - General and Chiropractic Coverage
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 220 - Chiropractic Documentation Requirements
- CMS Medicare Learning Network (MLN) Matters Special Edition (SE)1101 - Chiropractic Services Policy Overview
- Title XVIII of the Social Security Act, Section 1862(a)(7)
- Title XVIII of the Social Security Act, Section 1862(a)(1)(A)
Last Updated Jul 28, 2017
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.