Does Medicare Pay for a Chiropractor?

Medicare provides coverage for medically necessary services. Understanding its specific coverage for chiropractic care requires attention to detail, as it focuses on particular treatments and conditions. This article clarifies what chiropractic services Medicare covers, associated requirements, costs, and practical steps for accessing this care.

Medicare-Covered Chiropractic Services

Medicare Part B specifically covers manual manipulation of the spine when it is medically necessary to correct a spinal subluxation. A spinal subluxation refers to a condition where the vertebrae, or bones in the spine, are out of position or their movement is restricted, potentially affecting nerves and causing pain or limited function. This manual adjustment is the only chiropractic service covered by Medicare.

Medicare does not cover other services often provided by chiropractors. These non-covered services include X-rays, massage therapy, acupuncture, nutritional counseling, electrical stimulation, ultrasound therapy, heat or cold therapy, and therapeutic exercises, if performed or ordered by a chiropractor. Medicare distinguishes between “active treatment” to correct a specific condition and “maintenance therapy.” Active treatment aims to improve a patient’s condition. Maintenance care, which seeks to prevent disease or maintain an already stable condition, is not covered once maximum therapeutic benefit has been achieved.

Medicare Part B Coverage Requirements and Costs

For Medicare Part B to cover spinal manipulation, the treatment must be considered medically necessary to correct a spinal subluxation that has resulted in a neuromusculoskeletal condition. The chiropractor providing the service must be licensed in their state. The treatment must be “active treatment,” meaning it aims for recovery or improvement of function, rather than maintenance. This requires ongoing assessment and documentation by the chiropractor to demonstrate continued medical necessity and progress.

Medicare Part B covers 80% of the Medicare-approved amount for these covered chiropractic services, but only after the annual Part B deductible has been met. For 2025, the annual Part B deductible is $257. Once the deductible is met, beneficiaries are responsible for the remaining 20% coinsurance.

Accessing Chiropractic Care Through Medicare

When seeking chiropractic care under Medicare, confirm the chosen chiropractor accepts Medicare assignment. This means they agree to accept the Medicare-approved amount as full payment for covered services and will bill Medicare directly. When a chiropractor accepts assignment, the patient is responsible only for the deductible and coinsurance. Patients can find Medicare-enrolled chiropractors through the Medicare.gov website.

Generally, a referral from a primary care doctor is not required for Medicare to cover chiropractic services; however, informing one’s doctor about the treatment plan is a sound practice. During initial visits, the chiropractor will conduct an examination to diagnose the subluxation and develop a treatment plan. Throughout care, the chiropractor must maintain thorough documentation justifying the medical necessity of each session, including patient history, physical examination findings, diagnosis, and a treatment plan with measurable goals. After receiving services, beneficiaries should review their Explanation of Benefits (EOB) from Medicare to understand what was covered and their financial responsibility.