Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Chiropractic Visits?

Medicare does not cover routine visits to the chiropractor. A Medicare benefit, however, does cover chiropractic care rendered in the course of rehabilitation for the following:

• Back injuries

• Spinal injuries

• Other injuries to bones, joints, ligaments, and tendons

Chiropractic care provided for conditions other than those listed above is not covered by Medicare.

Will medicare pay for a second opinion?

Medicare will pay for a second opinion of a Medicare-covered condition once every 12 months.

What are Medicare's limitations on physical therapy?

Medicare will pay for physical therapy if there are limitations on a person's ability to function. Your doctor must certify that you need the physical therapy for a particular condition.

Medicare will not pay for physical therapy if the purpose is to improve your overall health or promote general wellness. This is because Medicare will not pay for routine physical examinations.

Medicare benefits are limited to physical therapy that can be documented to be medically necessary. Medicare will not pay for physical therapy that is used as a substitute for treatment or surgery.

It does not pay for physical therapy prescribed to correct a general health problem, such as obesity, smoking cessation, or exercise for general conditioning.

Medicare will only pay for physical therapy that is ordered by a physician. Physician assistants and physical therapist assistants cannot order physical therapy and Medicare will not pay for it.

Medicare will pay for limited physical therapy treatment to alleviate pain, but only for the first 20 visits in a year.

Will medicare pay for chiropractic visits in a foreign country?

Medicare will pay for some chiropractic care provided in a foreign country. Medicare beneficiaries can get limited chiropractic services in a foreign country if they are participating in a Medicare demonstration project that is called the "Part B demonstration project for Chiropractic services outside the United States".

This demonstration project is limited to the following:

• Chiropractic services that are provided to a Medicare beneficiary who is temporarily outside the country

• Chiropractic services for a period of 6 months or less

• Chiropractic services that are not provided in the beneficiary's home country

• Chiropractic services that are provided in an area where the services are not available from people who are licensed to practice in the beneficiary's home country

• Chiropractic services that are provided by a licensed chiropractor

Will medicare pay for visits to a chiropractor?

Medicare may pay for chiropractic services when they are ordered by your primary care doctor to treat a medical condition. For example, Medicare will pay if your doctor recommends chiropractic care for back pain or a spinal condition.

Medicare may also pay for chiropractic services for rehabilitation following a work injury or an injury caused by a motor vehicle accident.

Medicare will not pay for chiropractic services that are prescribed for general health maintenance.

Medicare has additional rules that require your doctor to order specific types of chiropractic services. These services include:

• Chiropractic care for back injuries

• Care for injuries to bones, joints, ligaments and tendons

• Physical therapy after a stroke

• Rehabilitation following a spinal cord injury

• Rehabilitation following surgery for a spinal condition

In addition, Medicare requires your doctor to document the need for the chiropractic care in your medical records. Medicare will not cover chiropractic care if the care is not ordered by your doctor.

Medicare will pay for treatments such as spinal manipulations, electric stimulation, adjustment of spinal structures, mobilization, and stretching.

Medicare will not pay for chiropractic services that are intended to diagnose or treat a disease.

Can I get chiropractic care if I'm covered by medicare part B?

Yes. If you have Medicare Part B, you can get chiropractic services if you need them for the following:

• Back pain

• Spinal conditions

• A condition affecting the joints, bones, muscles, tendons, or ligaments

• Other conditions affecting the musculoskeletal system

Medicare pays for part of the cost of chiropractic services when they are prescribed by a doctor.

Medicare does not pay for chiropractic services that are used to improve or maintain your general health.

Medicare will only cover chiropractic services if they are part of a treatment plan that your doctor has ordered.

What are the rules for physical therapy services?

Medicare will pay for physical therapy services if you need them to help you function. If you have a disease or illness, Medicare will not pay for physical therapy services.

Medicare will pay for physical therapy if you need it for the following:

• A chronic disease

• Heart problems

• Breathing problems

• Poor circulation

• A condition of the nervous system

• Paralysis

• Other conditions that affect the body's ability to function

Medicare will not pay for physical therapy services if you are only in need of therapy that promotes general health or wellness.

Medicare will not pay for physical therapy services if your doctor prescribes them as a substitute for treatment that is provided by a doctor.

Medicare will only pay for physical therapy that is ordered by a doctor. Physical therapist assistants and physician assistants cannot order physical therapy, and Medicare will not pay for it.

Medicare limits the amount of physical therapy that it will cover. Medicare will only cover physical therapy for 20 visits in a year, and physical therapy for your spine cannot exceed 10 visits in a year.

Medicare will only pay for physical therapy certified by the physical therapist or doctor. It will not pay for physical therapy services that are not authorized by your doctor.

Will medicare pay for chiropractic

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