Medicare covers chiropractic care for correcting a vertebral subluxation, which is when the spinal joints do not move properly but the contact between the joints remains intact.
Individuals use chiropractic treatments to help relieve musculoskeletal problems, including neck, joint, and back pain. Trained chiropractors can also treat some headaches.
This article explains which chiropractic services Medicare covers, as well as some other Medicare-funded treatments for back pain.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare covers chiropractic manipulation of the spine to correct a
However, Medicare does not cover chiropractic manipulations as maintenance or preventive services. Additionally, it does not cover massage therapy, acupuncture, or X-rays, if a chiropractor orders them.
If a chiropractor offers or recommends any of these services, a person should ask about the cost of each, as they will need to fund the treatment themselves.
However, Medicare will pay for an X-ray if a doctor orders it as part of a medically necessary diagnosis. The results of the X-ray could indicate that a referral to a chiropractor is medically necessary.
Medicare resources
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Medicare Part B, the portion that helps people pay for doctor visits and some related treatments, covers chiropractic care to correct a vertebral subluxation.
Once a person meets their yearly deductible, which is $240 for Part B in 2024, Medicare will usually fund 80% of the cost of this chiropractic treatment.
The specific amount a person owes may depend on several factors, such as:
- whether their doctor accepts assignment
- where they get the service
- other insurance they may have
- how much their doctor charges
- the type of healthcare facility
Chiropractors address a range of spinal and other treatments, and the costs vary according to location, treatment, and the number of sessions.
According to an
Medicare may cover other back pain services, medical treatments, and some alternative therapies, including the below.
Acupuncture
Acupuncture refers to the practice of inserting tiny needles into the body to restore energy flow and reduce pain. In January 2020, the Centers for Medicare & Medicaid Services announced that Medicare would cover acupuncture to treat chronic low back pain.
The program will cover up to 12 sessions over 90 days, with a potential eight additional sessions if symptoms are improving.
Physical therapy
Physical therapy involves using exercises to strengthen and stretch the back and treat back pain. Medicare Part B covers any physical therapy service a doctor recommends to treat back pain. A person is responsible for 20% of the Medicare-approved amount up to their deductible for treatments.
Other alternative therapies
Medicare does not currently cover massage therapy, so a person is responsible for 100% of the costs of this treatment for back pain.
It is important to note that coverage for Medicare changes frequently and often expands to include more treatments. The Medicare website has a useful tool that people can use to search for a particular service to determine whether the program provides coverage.
Although chiropractic treatment may be effective for relieving specific pains, some chiropractors have made unsubstantiated claims about the benefits of the practice for nonmusculoskeletal conditions. However, a
Most chiropractors have since abandoned the idea that spinal manipulation can help treat conditions with no link to the spine.
Still, chiropractic care serves as an alternative to other treatment options for pain and discomfort, such as surgery or pain medications.
Some conditions a chiropractor can treat include the following:
- back pain
- conditions affecting the joints, ligaments, and muscles
- headaches
- neck pain
Medicare Part B covers chiropractic manipulation of the spine to correct a vertebral subluxation, which may cause back pain. However, it does not cover chiropractic care for other reasons.
Other back pain therapies Medicare may cover in certain circumstances include acupuncture and physical therapy.
A note on insurance
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