Medicare covers chiropractic visits, but only for one specific treatment: spinal manipulation to fix a misaligned vertebra

Original Medicare (Part A and Part B) will pay for chiropractic care, but the coverage is narrow. Medicare covers spinal manipulation — the adjustment of vertebrae — when a doctor or chiropractor documents that a vertebra is out of place and causing a medical problem. Medicare does not cover other chiropractic services like massage, ultrasound, X-rays ordered by a chiropractor, or general wellness visits.

You need a referral from your primary care doctor or another physician before Medicare will pay. The chiropractor must also be enrolled in Medicare and accept Medicare payment. If you see a chiropractor who is not Medicare-enrolled, you will pay the full cost yourself.

Medicare Part B covers up to 12 chiropractic visits per year for spinal manipulation, though your doctor may authorize more if medically necessary. You pay 20 percent of the Medicare-approved amount after you meet your Part B deductible.

Key Takeaways

  • Medicare covers spinal manipulation only when a physician has documented that a vertebra is misaligned and causing a medical condition.
  • You must have a referral from your doctor before a chiropractor can bill Medicare for the visit.
  • The chiropractor must be enrolled in Medicare; if they are not, Medicare will not pay and you will owe the full fee.
  • Medicare Part B covers up to 12 visits per year for spinal manipulation, and you pay 20 percent of the approved cost after your deductible.
  • Medicare does not cover other chiropractic services such as massage, heat therapy, or X-rays ordered by the chiropractor.

How to get a referral from your doctor

Your primary care doctor or another physician must refer you to a chiropractor for Medicare to cover the visit. You do not need a formal written referral form — your doctor can document the referral in your medical record, and the chiropractor's office will request those records from your doctor's office before your first visit.

Tell your doctor that you want to see a chiropractor for spinal manipulation and describe the problem — for example, a pinched nerve or misaligned vertebra causing back pain. Your doctor will decide whether spinal manipulation is appropriate for your condition. If your doctor agrees, they will note it in your chart, and you can then schedule with a Medicare-enrolled chiropractor.

Some chiropractors' offices will call your doctor's office directly to confirm the referral and get the medical documentation they need. This can speed up the process, so ask the chiropractor's office whether they do this.

Finding a Medicare-enrolled chiropractor

Not all chiropractors accept Medicare. You can search for one who does on the Medicare Provider Lookup tool at Medicare.gov. Go to the "Care Provider" search, select your state, and search for "chiropractor." The results will show which chiropractors in your area are enrolled in Medicare.

When you call to schedule, tell the office that you have Medicare and ask whether they accept Medicare payment. Confirm that they are enrolled in Medicare and that they will bill Medicare directly for spinal manipulation visits. Some offices accept Medicare for certain services but not others, so it is worth asking specifically about spinal manipulation.

If you use a Medicare Advantage plan (Part C) instead of Original Medicare, your plan may have different rules about chiropractic coverage. Some Medicare Advantage plans cover more chiropractic visits or do not require a referral. Check your plan's coverage details or call the plan's customer service number on the back of your card.

What happens during your visit and how Medicare pays

At your first visit, the chiropractor will examine you and may take X-rays or other images to document the misalignment. Medicare will only pay for the spinal manipulation itself, not for the imaging or other diagnostic tests the chiropractor orders. You may be billed separately for those services.

The chiropractor will perform the spinal manipulation adjustment. This is the only service Medicare covers. If the chiropractor also provides massage, heat therapy, ultrasound, or other treatments during the same visit, you will be billed for those separately — Medicare does not cover them.

After the visit, the chiropractor's office bills Medicare directly. Medicare pays 80 percent of the approved amount, and you pay 20 percent (after you have met your Part B deductible for the year). The amount you owe depends on what Medicare considers the approved charge for spinal manipulation in your area, not what the chiropractor charges.

The 12-visit limit and when you can get more

Medicare covers up to 12 chiropractic visits per calendar year. If you need more than 12 visits, your doctor can request an exception from Medicare, but this is not automatic. Your doctor will need to document that additional visits are medically necessary for your condition.

The 12-visit limit resets on January 1 each year. If you use 10 visits in 2024, you will have 12 new visits available starting January 1, 2025.

Some people reach the 12-visit limit before their condition improves. If this happens, talk to your doctor about whether more visits are medically necessary. Your doctor can submit a request to Medicare for additional coverage, though approval is not may provide. In the meantime, you can continue to see the chiropractor and pay out of pocket, or explore other treatment options with your doctor.

What Medicare does not cover

Medicare does not cover chiropractic services other than spinal manipulation. This means you will pay out of pocket for:

  • Massage therapy or soft tissue work
  • Heat therapy, ice therapy, or ultrasound
  • X-rays or imaging ordered by the chiropractor
  • Nutritional counseling or supplements
  • Wellness or preventive visits (visits without a documented medical problem)
  • Visits for conditions other than vertebral misalignment

If a chiropractor's office bills Medicare for services other than spinal manipulation, that is not allowed. If you are billed by Medicare for a service you did not receive or that should not have been billed, contact Medicare at 1-800-MEDICARE to report it.

Medicare Advantage plans and chiropractic coverage

If you have a Medicare Advantage plan (Part C), your coverage for chiropractic care may be different from Original Medicare. Some Medicare Advantage plans cover more than 12 visits per year, do not require a referral, or cover additional chiropractic services like massage. Other plans may cover fewer visits or have higher out-of-pocket costs.

Check your plan's Summary of Benefits document or call your plan's customer service line to find out what chiropractic services are covered and how many visits you have per year. The number on the back of your Medicare Advantage card will connect you to your plan's customer service team.

Frequently Asked Questions

Do I need a referral if I have a Medicare Advantage plan?

It depends on your plan. Some Medicare Advantage plans do not require a referral for chiropractic care, while others do. Check your plan's coverage details or call your plan's customer service number to find out.

What if my chiropractor is not enrolled in Medicare?

If your chiropractor is not enrolled in Medicare, Medicare will not pay for your visit. You will owe the full cost. You can search for Medicare-enrolled chiropractors in your area using the Medicare Provider Lookup tool at Medicare.gov.

Can I use my remaining visits next year if I do not use all 12 this year?

No. Your 12 visits reset on January 1 each year. Any unused visits from the previous year do not carry over. Plan your visits accordingly if you know you will need chiropractic care.

Will Medicare pay for chiropractic care for neck pain or other conditions besides back pain?

Yes, if a doctor has documented that a vertebra is misaligned and causing the pain. Spinal manipulation can be used on the neck (cervical spine) or lower back (lumbar spine) as long as there is a medical reason and a physician referral.

What should I do if I am billed for chiropractic services Medicare should have covered?

Contact Medicare at 1-800-MEDICARE to report the billing error. Have your Medicare number and the chiropractor's name and office address ready. Medicare can investigate and correct the billing if an error occurred.