Spinal decompression therapy helps relieve back pain by reducing spinal pressure and addressing disk issues, pinched nerves, sciatica, and spinal stenosis. It can be nonsurgical or surgical.
In most cases, Original Medicare (parts A and B) does not cover spinal decompression therapy, citing “insufficient evidence” for its effectiveness. For this reason, Medicare Advantage (Part C) plans do not offer this procedure as part of their standard benefits, though some plans may offer benefits Original Medicare does not offer.
Original Medicare considers spinal decompression therapy an experimental procedure. However, it may cover a specific type of this procedure, percutaneous image-guided lumbar decompression (PILD), as part of a clinical trial.
PILD addresses lumbar spinal stenosis, a condition where the spinal canal in the lower back becomes narrow. During PILD, medical experts use small tools to remove thickened ligament parts from the spinal canal to create additional space. This procedure may relieve pressure and minimize pain and discomfort.
In the case of a clinical trial involving PILD, Original Medicare might cover a person’s medical care as part of the covered trial. The out-of-pocket cost of the procedure or services depends on the Medicare part that provides coverage.
PILD is typically a minimally invasive procedure that doctors can perform on an outpatient basis, which means that coverage should fall under Part B.
Part B requires meeting an annual deductible of $257, after which it covers 80% of treatments. The monthly premium starts at $185 in 2025.
In case of hospitalization, coverage falls under Part A, which typically requires no premium but has a $1,676 deductible. Part A covers hospitalization for the first 60 days.
Part C plans have varying premiums, deductibles, and coinsurances. The average monthly premium is around $17.00 in 2025, and you must still pay the Part B premium, though some Part C plans may cover it.
Medicare provides coverage for various other back pain treatments. However, the only type of chiropractic adjustment Medicare Part B covers is manual spinal manipulation for vertebral subluxation.
Other coverage may include:
- acupuncture for chronic low back pain under Medicare Part B
- steroid injections for back pain under Medicare Part B or oral medications for back pain under Medicare Part D
- certain procedures, such as radiofrequency ablation, when deemed medically necessary under Medicare Part A or B
Part C must also offer any coverage provided by Original Medicare.