Medicare's Coverage of Chiropractic Services

Medicare Part B covers chiropractic care, but only for one specific service: spinal manipulation to correct a vertebral subluxation. This is the only chiropractic treatment Medicare will pay for. If your chiropractor performs any other service — such as X-rays, massage, heat therapy, or nutritional counseling — Medicare does not cover those treatments, even if the same visit includes a covered spinal manipulation.

A vertebral subluxation is a misalignment of the spine that a chiropractor diagnoses and then corrects through manual adjustment. Medicare requires that the subluxation be documented on imaging (usually X-rays taken by the chiropractor) and that the treatment be medically necessary. The chiropractor must also be licensed in the state where they practice.

Medicare pays 80 percent of the approved amount for spinal manipulation after you have met your Part B deductible. You pay the remaining 20 percent, plus any amount the chiropractor charges above Medicare's approved fee schedule — called balance billing — unless the chiropractor accepts Medicare assignment.

Key Takeaways

  • Medicare Part B covers spinal manipulation for vertebral subluxation only; no other chiropractic services are covered.
  • Your chiropractor must document the subluxation with imaging and show that treatment is medically necessary for Medicare to pay.
  • You pay 20 percent of the approved amount after your Part B deductible is met, plus any balance billing if your chiropractor does not accept Medicare assignment.
  • Supplemental insurance (Medigap) or Medicare Advantage plans may cover some or all of your 20 percent cost-share, depending on the plan.
  • Many chiropractors do not accept Medicare, so confirm in advance that your provider is in-network or accepts Medicare payment.

How to Know if Your Chiropractic Visit Will Be Covered

Before you schedule an appointment, call your chiropractor's office and ask whether they accept Medicare and whether they accept Medicare assignment. Accepting assignment means the chiropractor agrees to charge only what Medicare approves and will not bill you for the difference. If they do not accept assignment, you could owe significantly more out of pocket.

When you arrive for your visit, bring your Medicare card. The chiropractor will perform an examination and, if they believe you have a vertebral subluxation, will order imaging — usually X-rays — to document it. Medicare requires this documentation before any treatment. If the chiropractor diagnoses a subluxation and treatment is deemed medically necessary, the visit may be covered. If the chiropractor finds no subluxation or recommends only preventive or wellness care, Medicare will not pay.

After your visit, the chiropractor's office will submit a claim to Medicare. You will receive an Explanation of Benefits (EOB) showing what Medicare approved, what you owe, and what the chiropractor can bill you. Review this carefully to catch any balance billing.

What Medicare Does Not Cover

Medicare does not cover chiropractic X-rays, even if they are used to diagnose a subluxation. You will be billed separately for imaging. Medicare also does not cover massage therapy, heat therapy, ultrasound, electrical stimulation, or any other modality a chiropractor might use alongside spinal manipulation.

Preventive or wellness visits — appointments aimed at maintaining spinal health rather than treating a diagnosed condition — are not covered. Similarly, treatment for conditions other than vertebral subluxation, such as headaches, neck pain, or lower back pain without documented subluxation, falls outside Medicare coverage. Some chiropractors may still treat these conditions, but you would pay out of pocket.

Nutritional counseling, ergonomic information, and home exercise programs are also not covered by Medicare, even if recommended by your chiropractor during a covered visit.

Costs and How to Manage Them

The cost you pay depends on whether you have met your Part B deductible for the year. In 2024, the Part B deductible is $240. Once you have paid $240 toward covered services, Medicare begins to pay its share. For a covered spinal manipulation, Medicare pays 80 percent of its approved amount, and you pay 20 percent.

The approved amount varies by location and the specific code used for the service. Medicare's approved fee for a single spinal manipulation typically ranges from $30 to $50, meaning your 20 percent cost-share would be roughly $6 to $10 per visit. However, if your chiropractor does not accept assignment, they can charge more, and you would owe the full difference.

If you have a Medigap (supplemental insurance) plan, it may cover some or all of your 20 percent cost-share. If you have a Medicare Advantage plan, check your plan documents to see whether chiropractic care is covered and what your out-of-pocket costs would be — coverage varies widely by plan.

Finding a Medicare-Accepting Chiropractor

Not all chiropractors accept Medicare. Some do not because the reimbursement is low, the documentation requirements are strict, or they prefer to operate outside the Medicare system. To find a chiropractor who accepts Medicare in your area, use the Medicare Provider Search tool on Medicare.gov. Enter your zip code and search for "chiropractor." The results will show which chiropractors in your area are enrolled in Medicare.

You can also call your local hospital or primary care doctor's office and ask for a referral to a Medicare-accepting chiropractor. Some physical therapy clinics also employ chiropractors who accept Medicare. When you contact the office, confirm not only that they accept Medicare but also that they accept assignment, so you know your costs in advance.

What Happens if Your Chiropractor is Out of Network

If you see a chiropractor who does not accept Medicare, Medicare will not pay anything toward the visit. You will owe the full cost out of pocket. Some chiropractors who do not accept Medicare may still submit a claim on your behalf as a courtesy, but they are not required to do so, and you remain responsible for payment regardless of what Medicare decides.

If you have a Medicare Advantage plan, the rules are different. Some Medicare Advantage plans include chiropractic coverage as an added benefit, but only if you use an in-network provider. Out-of-network chiropractors are typically not covered at all under these plans. Check your plan's provider directory or call the plan to confirm which chiropractors are in-network before scheduling.

Frequently Asked Questions

Does Medicare cover chiropractic care for back pain?

Medicare covers spinal manipulation only if a chiropractor diagnoses a vertebral subluxation and documents it with imaging. Back pain alone does not may have access to for coverage. If your back pain is caused by a subluxation, treatment may be covered; if it is caused by something else, it will not be.

Can I see a chiropractor without a referral from my doctor?

No referral is required to see a chiropractor under Medicare Part B. You can schedule an appointment directly. However, your primary care doctor may recommend a chiropractor, and some Medicare Advantage plans do require a referral before covering chiropractic care, so check your plan's rules.

How many chiropractic visits does Medicare cover per year?

Medicare does not set an annual limit on the number of spinal manipulation visits covered. However, each visit must be medically necessary and documented as treatment for a vertebral subluxation. If Medicare determines that visits are no longer medically necessary, it will stop paying. Your chiropractor should discuss expected treatment duration with you upfront.

Will my Medicare Advantage plan cover chiropractic care?

Some Medicare Advantage plans include chiropractic coverage as an added benefit, but not all do. Coverage, cost-sharing, and visit limits vary by plan. Check your plan's Summary of Benefits or call the plan directly to find out whether chiropractic care is covered and what you would pay.

What if my chiropractor bills me more than Medicare approves?

If your chiropractor accepts Medicare assignment, they cannot bill you more than Medicare's approved amount. If they do not accept assignment, they can charge above the approved amount, and you are responsible for the difference. Always confirm whether your chiropractor accepts assignment before your first visit.