Medicare Chiropractic Coverage

Chiropractic care covered by Medicare
Medicare does pay for:

• Manual adjustment of the spine to correct a subluxation

A subluxation occurs when one or more bones of the spine move out of position or the joint movement becomes restricted. Subluxation typically affects nerves and results in pain and/or limited movement.

Care for a subluxation is defined as “active treatment.” Ongoing active treatment must demonstrate improved function for Medicare to continue to provide payment. Your doctor of chiropractic will periodically re-evaluate your progress and response to care.

Participating provider
Northwestern Health Clinic – Bloomington is a participating Medicare provider and accepts Medicare assignments. According to Medicare policy, you pay 20% of the Medicare-approved amount and the Part B deductible applies.

Chiropractic care not covered by Medicare
Medicare does not pay for:

• Maintenance chiropractic care after your condition is corrected or stabilized
• Examinations and X-rays
• Extremity treatments
• Ultrasound, electrical therapy, and tool–assisted therapies
• Acupuncture or massage
• Therapeutic exercise instruction or supervised exercise

For maintenance care – ABN form required
Many patients feel they would benefit from a chiropractic maintenance care plan after their condition has been corrected or stabilized. However, Medicare does not provide coverage for maintenance care.

If you decide to receive maintenance care or other services that may not be covered, you will be asked to sign an Advance Beneficiary Notice (ABN) form required by Medicare. This form confirms that you understand Medicare does not provide coverage for these services and that you agree to pay for the services.