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Medicare and Chiropractic Care

Posted by Paul Rose on 3/13/20 4:36 PM


Do your clients suffer from back pain? According to Harvard Health Publishing, about 85 percent of people do. Treating back pain can be difficult, but a 2018 study found that after six weeks of chiropractic treatment, patients reported less pain intensity, less disability, higher satisfaction with treatment and a reduced need for pain medicine.

Many people find relief in chiropractic care, but sessions can be pricey. For people who need multiple sessions over a long period of time, the out-of-pocket costs can really add up. The good news is that sessions may be covered under Medicare.

The Popularity of Chiropractic Care

According to a 2017 study from the CDC, more than 10 percent of the U.S. adult population used chiropractic care during the previous 12 months. This is a slight increase from 2012, when 9.1 percent of people said they received chiropractic care.

The National Center for Complementary and Integrative Health says that chiropractic treatment typically involves manual therapy, such as joint manipulation and stretching, and it may be combined with exercise and nutritional counseling.

In addition to meeting their state’s licensing requirements, chiropractors must earn a Doctor of Chiropractic (D.C.) degree and pass the National Board of Chiropractic Examiners exam to practice in the U.S.

Medicare Coverage for Chiropractic Care

Medicare provides some coverage for chiropractic services. Specifically, Medicare Part B covers manual manipulation of the spine to correct a subluxation. The treatment must be medically necessary, and it must be provided by a chiropractor or other qualified provider. Beneficiaries receiving covered chiropractic care will pay 20 percent of the Medicare-approved amount plus the Part B deductible.

Medicare Part B does not cover tests that are ordered by a chiropractor. For example, if your chiropractor orders X-rays, those X-rays won’t be covered. Other services that are ordered by the chiropractor, such as massage therapy, won’t be covered, either.

Some people feel that these benefits don’t provide enough coverage. According to Chiropractic Economics, the Chiropractic Medicare Coverage Modernization Act would provide improved coverage under Medicare, and it could help some people avoid prescription opioid pain medications.

CMS just announced a final rule that will provide coverage for acupuncture to treat chronic low back pain, citing the opioid crisis as a major motivation for the change, so expanded coverage for chiropractic care may be possible in the future. In the meantime, beneficiaries may look to Medicare Advantage plans for additional coverage.

Medicare Advantage plans often provide additional benefits on top of those covered by Original Medicare. These services may include more robust chiropractic care coverage. Some Medicare Advantage plans may even provide coverage for massage therapy services. Benefits vary from plan to plan, though, so see the plan’s benefit information for details.

Get the Most out of Coverage

Help your clients get the most out of their chiropractic care coverage with these tips.

  • Check coverage for chiropractic care before receiving treatment.
  • Remember that additional tests and services ordered by the chiropractor won’t be covered under Original Medicare. If the chiropractor thinks tests are needed, talk to your primary care provider.
  • Check Medicare Advantage plans in your area for additional chiropractic and massage therapy benefits.

Topics: Medicare, Medicare and chiropractic care, chiropractic care

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