Medicare and Chiropractic


Can I use Medicare for Chiropractic

The short answer is yes you can.  However, we know it can to be that simple.  Medicare covers the chiropractor for the correction of vertebral subluxation.  The subluxation is what chiropractors adjust trying to reduce.  Medicare now has a very fair system that allows patients to use part B and be covered.

How many visits?

According to the way the medicare law is written, there is no limit.  However, the chiropractor must be able to demonstrate that you actually need the care.  Meaning, your spinal subluxation must be interfering with you preforming your every day activities.  Here are a few reasons, if you can not do the follow without discomfort-

  • Rising out of chair
  • Unable to sleep
  • Standing too long
  • Reaching
  • Pulling
  • Walking
  • Staying Asleep
  • Simple household chores
  • Simple outside chores
  • Carrying Groceries
  • Using a computer
  • Looking over your shoulder

Just to name a few.  These are called activities of daily living.  Your chiropractor must document these.  As a result, often a questionnaire will be used.  These questionnaires are used in all health care fields.

Not so simple part

It is also the responsibility to demonstrate you need the care.  Medicare accepts to forms of proof.  One would be a lengthy chiropractic exam.  However, this exam is valid only for your current complaint.  Here is an example, your lower back hurts when you are sitting.  First thing is the exam on your lower back.  As a result, your exam finds prove your lower back is in need of care.  Next, two weeks later you sleep wrong and now your neck is tight.  Because you have a new complaint you will need a new examination.  Medicare will not cover the cost of the exam.

The other proof that medicare accepts is imaging.  X-rays are the common form of imaging in a chiropractic clinic.  Your images are valid for any complaint within one year of being taken.  So like above if you have lower back pain today and next month your neck hurts, you would not need new images.  As a result, many Chiropractors choose to use images to document need of care.  The other bonus is images tell us so much more vs. having an exam.  Finally, medicare again does not cover the cost of imaging.


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