Medicare Part B covers a limited type of chiropractic service: manipulation of the spine to correct a subluxation, when the service meets Medicare requirements. It is not general coverage for every service offered by a chiropractic office.
Covered service versus other office charges
| Service | Original Medicare distinction |
|---|---|
| Qualifying spinal adjustment | A chiropractor may use hands or an activator device to correct a subluxation. |
| X-rays ordered by the chiropractor | Not covered under Medicare’s chiropractic benefit. |
| Massage or acupuncture ordered by the chiropractor | Not covered under this benefit; acupuncture has separate, limited coverage requirements. |
| Other office services or packages | Do not assume they are covered because a spinal adjustment is covered. |
A subluxation involves spinal joints that do not move properly while remaining in contact. Ask the office which service is being billed and why it meets Medicare’s coverage rules. This article does not recommend a treatment or a schedule of visits.
What you may pay
For covered chiropractic services under Original Medicare, you generally pay 20% of the Medicare-approved amount after the Part B deductible. Ask whether the provider accepts assignment and request separate estimates for covered and noncovered services. Do not interpret Medicare enrollment by the provider as a guarantee that every charge is covered.
Medigap and Medicare Advantage
Medigap can help with specified Original Medicare deductibles or coinsurance according to the policy. It generally does not turn an excluded chiropractic service into a Medicare-covered benefit. Confirm the exact policy’s benefits rather than relying on the word “supplement.”
Medicare Advantage covers required Medicare benefits and may offer additional benefits. Check the exact plan’s network, referrals, authorization rules, visit conditions and cost sharing. Extra services advertised by one plan do not establish benefits for all plans from the same carrier.
Questions for the billing office
- Which spinal service is being proposed and which charges are separate?
- What amount is expected from Medicare or my plan?
- What deductible, coinsurance or noncovered charge could I owe?
- Will any advance notice be required?
- Where can I find the decision and appeal instructions if coverage is denied?
Related coverage questions
- Medicare Part B Physical Therapy: Coverage and Costs
- Medicare Acupuncture and Dry Needling Coverage: The Limits