Medicare covers chiropractic adjustment, but only for the spine and only under specific conditions

Medicare Part B covers chiropractic adjustment of the spine when a doctor has diagnosed a condition that needs it. Medicare does not cover other chiropractic services — such as X-rays, massage, or adjustments to other parts of your body. You pay 20% of the cost after you meet your Part B deductible, and the chiropractor must be enrolled in Medicare.

The amount Medicare pays depends on where you live and which chiropractor you see. Medicare sets a fee schedule for each region, and that amount varies. Your out-of-pocket cost is always 20% of what Medicare approves, regardless of what the chiropractor charges.

Key Takeaways

  • Medicare Part B covers spinal manipulation only when ordered by a doctor for a condition like a subluxation or acute neck or back pain.
  • You pay 20% of the Medicare-approved amount after meeting your annual Part B deductible (currently $240 in 2024, though this changes yearly).
  • Medicare does not cover chiropractic X-rays, massage, or adjustments to joints other than the spine.
  • The chiropractor must be enrolled in Medicare and accept Medicare payment for the visit to be covered.
  • There is no limit on the number of spinal adjustments Medicare will pay for, as long as a doctor continues to order them and they remain medically necessary.

What Medicare actually pays for

Medicare covers manipulation of the spine when a licensed chiropractor performs it under a doctor's order. The doctor must document that you have a condition that needs spinal manipulation — typically a subluxation (a vertebra out of alignment) or acute neck or back pain. The doctor does not have to be the one who diagnoses the condition; your regular doctor can refer you based on another provider's assessment.

The Medicare-approved amount for a spinal adjustment varies by region and by the specific type of adjustment. In most areas, a single adjustment costs Medicare between $30 and $50, though this range shifts based on your location and the complexity of the service. You pay 20% of that approved amount.

Medicare does not cover adjustments to your shoulders, knees, ankles, or any joint other than the spine. It also does not cover X-rays taken at the chiropractor's office, even if the chiropractor says they are needed to plan treatment. If you need imaging, ask your doctor to order it at a facility that accepts Medicare.

How much you pay out of pocket

Your cost for a chiropractic adjustment is 20% of the Medicare-approved amount, after you have met your Part B deductible for the year. The Part B deductible is $240 in 2024, but Medicare adjusts this amount each year. Once you reach that deductible, you pay 20% for all covered services for the rest of the calendar year.

If the chiropractor is not enrolled in Medicare, or if they do not accept Medicare assignment (meaning they agree to accept Medicare's payment as full payment), you may owe more. When a provider accepts assignment, they cannot bill you for the difference between their fee and Medicare's approved amount. If they do not accept assignment, you could be billed for that difference on top of your 20% coinsurance.

Before your first visit, ask the chiropractor's office whether they are enrolled in Medicare and whether they accept assignment. This protects you from unexpected bills.

When Medicare requires a doctor's order

A doctor must order the spinal adjustment before you see the chiropractor. This order is called a referral or prescription, depending on your plan. The chiropractor cannot bill Medicare for the visit without this documentation.

Your primary care doctor, a specialist, or any licensed physician can write the order. If you already see a chiropractor and want Medicare to cover it, ask your doctor to send a referral. The doctor needs to state that spinal manipulation is medically necessary for your condition. This is usually a straightforward phone call or message to your doctor's office.

Medicare does not limit how many adjustments you can receive, as long as your doctor continues to order them and they remain medically necessary. However, if you go to the chiropractor without a current order, that visit will not be covered.

Finding a Medicare-enrolled chiropractor

Not all chiropractors accept Medicare. To find one who does, use the Medicare Provider Search tool on Medicare.gov. Enter your zip code and select "Chiropractor" as the provider type. The search will show you chiropractors in your area who are enrolled in Medicare.

When you call to schedule an appointment, confirm that they accept Medicare assignment. Ask whether they will file the claim for you or whether you need to submit it yourself. Most enrolled chiropractors file claims directly with Medicare, which is simpler for you.

If you use a chiropractor who is not enrolled in Medicare, you will have to pay the full fee upfront and then submit a claim yourself. Medicare may reimburse you for part of the cost, but you will not know the amount until after you file.

Supplemental insurance and Medicare Advantage plans

If you have a Medigap (supplemental) policy, it may cover some or all of your 20% coinsurance for chiropractic care. Check your policy documents or call your supplemental insurance company to confirm what they cover.

If you have a Medicare Advantage plan (Part C), your coverage for chiropractic care may be different from Original Medicare. Some Advantage plans cover spinal manipulation; others do not. Some plans limit the number of visits per year. Check your plan's summary of coverage or call the plan to ask about chiropractic benefits before you schedule an appointment.

What to do if your claim is denied

If Medicare denies a claim for chiropractic adjustment, the chiropractor's office or Medicare will send you a notice explaining why. Common reasons for denial include: no doctor's order on file, the order expired, the condition was not deemed medically necessary, or the chiropractor is not enrolled in Medicare.

If you believe the denial is wrong, you have the right to appeal. The notice will include instructions on how to file an appeal and the important date for doing so. You can also contact your local Medicare office or call 1-800-MEDICARE for help understanding the denial.

Frequently Asked Questions

Does Medicare cover chiropractic care for my neck pain?

Yes, if a doctor has ordered it. Medicare covers spinal manipulation for acute neck pain or a diagnosed subluxation. You will need a referral from your doctor before the chiropractor can bill Medicare. The chiropractor must also be enrolled in Medicare.

What if my chiropractor charges more than Medicare approves?

If the chiropractor accepts Medicare assignment, they cannot charge you more than 20% of the approved amount. If they do not accept assignment, they can bill you for the difference, which could be substantial. Always confirm assignment before your visit.

How many chiropractic visits does Medicare cover per year?

Medicare does not set a yearly limit on chiropractic visits. You can receive as many adjustments as your doctor orders and Medicare deems medically necessary. However, if Medicare stops approving the visits as necessary, coverage will end.

Can I see a chiropractor without a doctor's referral and pay out of pocket?

Yes. If you pay the full fee yourself, you do not need a doctor's order. However, Medicare will not reimburse you for visits without a referral, so you will bear the entire cost.

Does Medicare cover chiropractic X-rays?

No. Medicare does not cover X-rays or imaging ordered by a chiropractor. If imaging is needed, ask your doctor to order it at a facility that accepts Medicare, and it may be covered under your Part B benefits.