Is a chiropractor covered by Medicare?
Finding chiropractors that accept Medicare doesn't have to be difficult. Most chiropractors will be covered under both Medicare and Medicaid. But if you need any additional testing, you might end up paying out of pocket for those expenses.
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UPDATED: Nov 22, 2021
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- Medicare does cover chiropractic services, but if you need any additional testing, you will have to pay out of pocket
- If you need any additional testing, such as an x-ray of massage therapy, your chiropractor may be able to refer you for Medicare to cover your expenses
- There are some Medicare Advantage plans that do pay for x-rays and other services if medically necessary
Finding chiropractors that accept Medicare may not be difficult, as most doctors accept Medicare as a standard practice, but it may be hard to get any additional services covered if you need them.
While Medicare does cover x-rays, massage therapy, and other pain management services that are included within all health insurance, if these services are ordered by a chiropractor, Medicare will not cover it because of specific guidelines associated with diagnosis and documentation.
Keep reading for more information on Medicare guidelines for chiropractic documentation and where to find a chiropractor that takes Medicare. Enter your ZIP code into our free tool to compare Medicare quotes in your area.
What does Medicare and Medicaid cover?
With both Medicare and Medicaid, most chiropractors will accept these forms of insurance.
According to the American Chiropractic Association, around 80% of people experience back pain at some point in their lives and the need for pain management related to back pain and injuries has been increasing steadily since 2010.
Between both Medicare and Medicaid, the coverage is going to look a bit different.
|Part A: Does not cover additional testing (such as, x-rays, massage therapy or acupuncture)||Some states charge beneficiaries a small copayment up to $3.80 per session for chiropractic treatment|
|Part B: Does not cover additional testing (such as, x-rays, massage therapy or acupuncture)||There may be some limitations to how many sessions Medicaid will fund; will vary state to state|
|Part C: May provide additional chiropractic coverage|
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If you’re eligible, Medicare will usually pay up to 80% of the Medicare-approved amount for chiropractic care through Part B. Policyholders are liable to pay the remaining 20% and the Part B deductible. As of 2021, the Medicare Part B deductible was rounded out to around $203.
If your chiropractor recommends other treatments not funded by Medicare or request tests such as X-rays before your treatment starts, you are responsible for covering the costs. If you have supplemental Medicare insurance, some of these costs may be covered, depending on the plan.
There is no limit to how many chiropractic sessions Medicare will cover if you’re eligible to receive these benefits, and funding caps are not permitted.
However, some Medicare Administrative Contractors (MACs) have policies that require the documentation and review of funding after a certain number of sessions.
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How do I find chiropractors that accept Medicaid near me?
If you’ve been searching fruitlessly for “Medicare chiropractic near me,” don’t worry. There are plenty of resources when it comes to finding a chiropractor that accepts either Medicare or Medicaid.
Both the Medicare and Medicaid websites have databases to search from when trying to find a local chiropractor in your area. These will help you in finding a doctor in-network and to help keep your costs covered.
Is a chiropractor covered by Medicare? Key Takeaways
Finding chiropractors that accept Medicare won’t be hard to do, since most chiropractors accept both Medicare and Medicaid. If needed, additional testing will be up to you to cover the costs of, unless you are referred.
Thankfully, there are some instances with both Medicare and Medicaid that will cover these tests, if it is deemed medically necessary.
Now that you’ve learned about chiropractors that accept Medicare, take the time to enter your ZIP code into our tool below and start comparing quotes in your area.