Does an FSA Cover Chiropractic Services?

Flexible Spending Accounts (FSAs) offer a tax-advantaged method for managing healthcare costs. These employer-sponsored benefits allow you to set aside pre-tax money from your paycheck for eligible out-of-pocket medical expenses. Funds contributed to an FSA are not subject to federal, state, or local taxes, reducing your overall taxable income.

FSA Eligibility for Medical Care

The Internal Revenue Service (IRS) establishes guidelines for eligible medical expenses. IRS Code Section 213 defines “medical care” as amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body. Expenses must be primarily for the alleviation or prevention of a specific health condition, rather than for general health or cosmetic purposes.

For an expense to be eligible, it cannot be reimbursed by insurance or any other source. Common eligible expenses include doctor visits, hospital stays, prescription medications, and certain medical equipment. A standard FSA covers a broad range of medical expenses, while a limited-purpose FSA is restricted to vision and dental expenses.

Specific Chiropractic Services Covered

Chiropractic care qualifies as an eligible medical expense for FSA reimbursement. Chiropractic treatments involve the diagnosis and treatment of musculoskeletal conditions, such as back pain, neck pain, and joint issues, aligning with the IRS definition of medical care. Services like chiropractic adjustments and manipulations are commonly covered. Diagnostic assessments, therapeutic exercises, and other physical therapy techniques provided during chiropractic visits also qualify.

However, eligibility hinges on medical necessity; treatments must address a specific health issue, not promote general wellness or maintenance. For instance, massage therapy may only be eligible if prescribed by a healthcare provider to treat a diagnosed medical condition, such as chronic pain or muscle injuries, rather than for relaxation. Nutritional supplements or non-medical services offered by a chiropractic clinic are not covered unless specifically prescribed for a medical condition and supported by documentation.

Documentation and Reimbursement Steps

Proper documentation is essential for chiropractic service reimbursement. When using an FSA debit card, transactions may be automatically approved, but retain itemized receipts for verification by the FSA administrator. Many FSA plans require itemized receipts showing the vendor name, date of service, a detailed expense description, and the amount paid. An Explanation of Benefits (EOB) from your insurance provider also serves as valid documentation.

For certain services, or if required by your FSA administrator, a Letter of Medical Necessity (LMN) from a licensed healthcare provider may be necessary. This letter should specify the medical condition being treated and how the chiropractic service, or related therapy, is essential for that treatment. Claims are submitted online, via an app, or by fax or mail, with processing usually occurring within a few business days. Always keep copies of all submitted documentation for your records, as the IRS mandates that all FSA expenses be substantiated.