Does Medicare Cover Chiropractic Care? Coverage, Limits & Costs

Medicare covers chiropractic care in very limited situations, and many beneficiaries misunderstand what is included and what is excluded. According to Medicare.gov, the official website of the U.S. Centers for Medicare & Medicaid Services (CMS), Original Medicare covers chiropractic services only for manual manipulation of the spine to correct a subluxation.

Understanding Medicare Parts Before Chiropractic Coverage

To understand chiropractic coverage, you must know how Medicare is structured. Medicare has four main parts:

• Part A: Hospital insurance
• Part B: Medical insurance
• Part C (Medicare Advantage): Private plans replacing Parts A and B
• Part D: Prescription drug coverage

Chiropractic services fall only under Medicare Part B, not Part A or Part D.

What Chiropractic Services Does Medicare Cover?

Medicare Part B covers one specific chiropractic service: Manual manipulation of the spine to correct a vertebral subluxation

What Is a Vertebral Subluxation?

A vertebral subluxation is defined by Medicare as:

• A misalignment of spinal bones
• A condition that can be shown through physical examination or imaging
• A problem causing pain, limited movement, or nerve interference

Medicare requires clinical documentation proving the subluxation exists and that treatment is medically necessary.

Covered Service Explained Simply

Medicare pays when:

• A licensed chiropractor performs hands-on spinal manipulation
• The goal is to correct the subluxation
• The treatment is active, not maintenance care

What Medicare Does NOT Cover for Chiropractic Care?

Here’s where many people get surprised. Medicare excludes several common chiropractic services.

Medicare Does Not Pay For:

• Initial chiropractic examinations
• Spinal X-rays ordered or taken by chiropractors
• Massage therapy
• Acupuncture (except limited cases unrelated to chiropractic)
• Physical therapy performed by a chiropractor
• Heat, ice, ultrasound, or electrical stimulation
• Maintenance or wellness adjustments

Numeric Example

A typical chiropractic visit costs:

• Initial exam: $150
• X-rays: $120
• Adjustment session: $65

Medicare covers only the $65 adjustment, and even that comes with cost-sharing.

How Much Does Medicare Pay for Chiropractic Visits?

Medicare Part B pays:

• 80% of the Medicare-approved amount
• After you meet the annual Part B deductible

2025 Medicare Part B Costs

• Annual deductible: $240
• Coinsurance: 20% per visit

Cost Example

If Medicare approves $50 for a spinal manipulation:

• Medicare pays: $40
• You pay: $10

That amount increases if:

• The chiropractor charges more than Medicare’s approved rate
• The visit includes non-covered services

Is There a Limit on Chiropractic Visits Under Medicare?

Medicare does not set a numeric visit limit, but it enforces medical necessity rules.

Medicare Stops Paying When:

• Your condition stops improving
• Treatment becomes maintenance care
• Documentation no longer shows active correction

In real terms, most beneficiaries receive:

• 12 to 24 covered visits per year
• Coverage ends once progress plateaus

Maintenance Care vs Active Treatment

Medicare draws a hard line here.

Active Treatment (Covered)

• Treatment improves function
• Pain levels decrease over time
• Range of motion increases

Maintenance Care (Not Covered)

• Adjustments to “stay aligned”
• Preventive visits
• Long-term wellness care

Medicare denies payment once care shifts from improvement to maintenance.

Does Medicare Advantage Cover Chiropractic Care?

Medicare Advantage (Part C) plans are different. Private insurers offering Advantage plans often include expanded chiropractic benefits.

Typical Medicare Advantage Chiropractic Coverage

• 20 to 30 visits per year
• Coverage for exams and X-rays
• Copays ranging from $10 to $30 per visit

Comparison

Feature	Original Medicare	Medicare Advantage
Exams covered	No	Yes (many plans)
X-rays covered	No	Often
Visit limits	Medical necessity	Fixed annual limit
Cost predictability	Variable	More predictable

Coverage varies by plan, ZIP code, and insurer.

Does Medigap Cover Chiropractic Care?

Medigap (Medicare Supplement) plans do not add new services. Medigap helps by:

• Paying the 20% coinsurance
• Covering deductibles in some plans

Medigap does not cover:

• Exams
• X-rays
• Maintenance care

Learn More: Aetna Dental Insurance Plans for Seniors

Can Chiropractors Bill Medicare Directly?

Yes, but conditions apply. A chiropractor must:

• Be licensed in the state
• Be enrolled in Medicare
• Accept Medicare assignment

If a chiropractor does not accept assignment, you may pay:

• Up to 15% more than Medicare-approved amounts

Case Study

Mary is 68 and lives in Ohio.

• Diagnosis: Lumbar subluxation
• Treatment plan: 18 spinal manipulations
• Medicare-approved rate: $50 per visit

Costs Breakdown

• Total approved amount: $900
• Medicare pays: $720
• Mary pays: $180

Mary also paid $220 out-of-pocket for exams and X-rays.

Why Medicare Limits Chiropractic Coverage?

Medicare’s chiropractic policy dates back to 1972.

CMS states that coverage focuses on:

• Medically necessary treatment
• Evidence-based improvement
• Cost control for preventive services

Medicare considers long-term chiropractic care a preventive or wellness service, which falls outside Part B’s scope.

Alternatives If You Need Ongoing Chiropractic Care

Several options exist if Medicare coverage falls short.

1. Medicare Advantage Plans

Best for predictable costs and extra benefits.

2. Employer or Retiree Health Plans

Some cover chiropractic visits fully.

3. Cash Packages from Chiropractors

Many clinics offer:

• Monthly plans: $70–$100
• Discounted bundles: 10 visits for $400

4. Health Savings Accounts (HSA)

Allowed only if paired with qualifying plans, not Original Medicare.

Common Myths About Medicare and Chiropractic Care

Myth 1: Medicare covers unlimited visits

Fact: Coverage stops when improvement stops.

Myth 2: Exams are included

Fact: Medicare excludes exams.

Myth 3: X-rays are covered

Fact: Chiropractor-ordered X-rays are excluded.

Final Thoughts

Chiropractic care plays a valuable role in pain management, especially for back and neck conditions. Medicare recognizes that value, but only within strict medical boundaries.

Smart planning makes the difference. Reviewing plan options, understanding documentation rules, and comparing Medicare Advantage benefits can save hundreds of dollars per year.

Before booking your next adjustment, confirm coverage details. Your spine deserves care, and your wallet deserves clarity.

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