In Medicare and You Handbook 2023, the Centers for Medicare and Medicaid Services (CMS) states:
Medicare covers manipulation of the spine by a chiropractor to
correct a subluxation (when the spinal joints fail to move properly, but
the contact between the joints remains intact). You pay 20% of the
Medicare-approved amount. The Part B deductible applies.
Note: Medicare doesn’t cover other services or tests a chiropractor orders,
other than manipulation of the spine.”
Yes, Medicare covers some chiropractic services. However, while the science of chiropractic has progressed, Medicare chiropractic coverage hasn’t been expanded since 1972 and is limited to manipulation of the spine when necessary to correct a subluxation. A subluxation has been described by Medicare as, “When one or more of the bones of your spine move out of position”. The subluxation must be associated with a symptomatic muscular and skeletal condition, for example, low back pain, disc herniation, sciatica, neck pain, etc. Medicare does not cover preventative chiropractic care. There is an effort by the American Chiropractic Association to achieve Medicare parity through the Chiropractic Medicare Coverage Modernization Act (H.R. 2654).
In my experience most Medicare patients also have a supplemental plan. The supplemental plan almost always only covers the Medicare annual deductible and 20% coinsurance. Medicaid will not pay if it is secondary. Medicare Advantage plans generally follow Medicare coverage but may have a higher copay.
The bottom line is that Medicare helps pay some of the cost of chiropractic services but does not cover any other chiropractic services, such as evaluation, any necessary x-rays, extremity adjustments, massage, or physiotherapy modalities (electrical stimulation, ultrasound, cold laser, traction, decompression), orthotics, etc. In my opinion, services not covered by Medicare are usually needed to provide appropriate patient care and get a good outcome. Most Americans can easily afford chiropractic services and chiropractic care may take the place of more costly and invasive procedures.
Greenville chiropractor Dr. Luke Henry has been a participating provider in Medicare since 2006. He has been a postgraduate speaker at chiropractic colleges, for the South Carolina Chiropractic Association, and has presented at medical and public health conferences. Dr. Henry is credentialed as an expert witness for the Office of Medicare Hearings and Appeals.