Does Medicare Cover Chiropractic Maintenance?

by | Last updated on January 24, 2024

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En español | Original Medicare pays for

only one

chiropractic service: manual manipulation of the spine if deemed medically necessary to correct a subluxation (when one or more of the bones in your spine are out of position).

How often does a chiropractor need maintenance?

Your lifestyle will determine the amount of maintenance treatment you will require. Those who sit for long, lift heavy loads, or do a lot of bending may require more maintenance. You may, therefore, need to come in

every two weeks

for an adjustment.

What is chiropractic maintenance therapy?

Maintenance therapy: includes “

services that seek to prevent disease, promote health and prolong and enhance the quality of life, or maintain or prevent deterioration of a chronic condition

.

Does Medicare pay for going to a chiropractor?


Medicare covers chiropractic visits for medically necessary manual manipulation of the spine

. “Medically necessary” means that the treatment is needed to diagnose or treat an illness, injury, condition or disease – or the related symptoms – and that it meets accepted standards of medicine.

What chiropractic codes does Medicare cover?

Doctors of chiropractic are limited to billing three Current Procedural Terminology (CPT) codes under Medicare:

98940 (chiropractic manipulative treatment; spinal, one to two regions), 98941 (three to four regions), and 98942 (five regions)

.

Does Medicare pay for massages?


Original Medicare (parts A and B) doesn’t cover massage therapy

, but it can cover other therapies like physical therapy and acupuncture. If you use massage therapy without Medicare coverage, you’ll be responsible for 100 percent of the costs. Medicare Advantage (Part C) may offer some coverage for massage therapy.

When should you stop seeing a chiropractor?

  1. Increased pain. It is not uncommon to note mild discomfort after the initial manipulation treatment for the first 24 to 48 hours (similar to starting a new exercise). …
  2. No improvement within 2 to 4 weeks. …
  3. Symptoms have gone away.

Why do chiropractors want you to keep coming back?

Changing your posture, changing your spine’s ability to move, changing your muscle health and structure take time. Months in fact.

All muscles have memory and your body wants to go back to its old patterns instead of creating new healthy ones

. That is why adjustments need to be repeated again and again.

Is going to the chiropractor twice a week too much?

When you are just starting a new treatment plan,

it’s common to have adjustments multiple times a week

. As your body begins to heal, that number could drop to just once a week. And if you are pain-free and simply wanting to maintain your lifestyle, you might only need to get an adjustment once or twice a month.

Is ongoing chiropractic care necessary?


Ongoing chiropractic care can help you to keep your spine aligned

, and an aligned spine is a stronger and more supported one. This can lead to a decrease in your risk of injury. When your body is balanced, then it’s less likely to fall victim to problems or a relapse of old issues!

What level of care and prevention is chiropractic care?

Chiropractors are recognized to be

primary health care

practitioners in many parts of the world, and consequently the regional Councils on Chiropractic Education state that a public health approach including health promotion should be implemented in chiropractic undergraduate programs [4–7].

What does part stand for in chiropractic?

PARTS acronym. P –

Pain/tenderness

. A – Asymmetry/alignment. R – Range of motion abnormality. T – Tone/texture/temperature of soft tissues.

Does Medicare cover spinal decompression?


Medicare covers chiropractic manipulation of the spine to help a person manage back pain, provided they have active back pain

. The program only funds chiropractic care that corrects an existing problem and does not cover spinal manipulations as maintenance or preventive services.

How many chiropractic visits do I need?

In most cases, you will experience some relief after

a week or two of regular visits

. If your pain does not subside, your chiropractor will encourage you to stick with it. They will ask you to come on a consistent basis a bit longer. In time, your pain will decrease and the frequency of your visits will reduce.

Is chiropractor covered by insurance?


Chiropractic treatment is covered by many insurance plans

. It has become the well-accepted treatment for acute pain and problems of the spine, including lower back pain and whiplash. Most chiropractors also adjust many other joints of the body, not just the spinal joints.

Is 97012 covered by Medicare?

There is insufficient scientific data to support the benefits of this technique. Therefore,

non-surgical spinal decompression is not covered by Medicare

(CMS Publication 100-03, Medicare National Coverage Determinations (NCD) Manual: Section 160.16).

What CPT codes do chiropractors use?

A. While there are three primary categories of CPT codes, most chiropractors use only Category 1 codes. The most common CPT codes used by chiropractors are

CPT Code 98940, CPT Code 98941, CPT Code 98942, and CPT Code 98943

.

What CPT codes can chiropractors bill?

  • 98940 Chiropractic Manipulative Treatment (CMT) …
  • 98941 Chiropractic Manipulative Treatment (CMT) …
  • 98942 Chiropractic Manipulative Treatment (CMT) …
  • 98943 Chiropractic Manipulative Treatment (CMT)

Does Medicare pay for myofascial release?

Most patients and massage therapists are not aware of the fact that

“massage therapy” and/or “manual therapy techniques/myofascial release” is a covered service by most insurers, including Medicare and self-insured employer plans

which fall under the Federal guidelines of ERISA (Employee Retirement Income Security Act) …

Does Medicare cover lymphatic drainage massage?


Medicare coverage for lymphedema therapy is limited

. Benefits do include manual lymphatic drainage, which is also known as lymphedema massage. To be covered, it must be performed by a qualified Medicare provider, such as a physical or an occupational therapist.

Does Medicare cover lymphatic massage?


Medicare doesn’t cover massage therapy

. You pay 100% for non-covered services, including massage therapy.

Why do doctors not like chiropractors?

Critics are skeptical mainly due to the fact that

chiropractic care does not involve medications or any invasive surgeries

. Some have associated this practice with some side effects and fatal complications in some cases resulting in death or stroke.

Why does chiropractor crack your neck?

So what happens when a chiropractor “cracks” a patient’s neck? The word or term “neck cracking” refers to the manipulation applied to the cervical joints, and a person hears a ‘crack’ or a popping sound. This occurs because

a quick motion is applied to the cervical area to loosen the neck’s ligaments and joints

.

What can you do instead of a chiropractor?

  • The Ancient Chiropractor Alternative: Massage. …
  • Yoga As an Alternative Form of Massage. …
  • Osteopathy Compared to Yoga Massage. …
  • Stretching Therapy: The Perfect Chiropractor Alternative.

How can you tell if you have a good chiropractor?


A good chiropractor will be slow to work their way into treatments and will ask you consistently about your feelings and pain levels throughout the treatment process

. A good chiropractor will understand that PAIN is the body’s sign of injury and that something is wrong.

Is it normal to see a chiropractor 3 times a week?

Depending on the severity of the underlying condition which is causing your pain,

it is typical for a patient to need chiropractic care or adjustments 2-3 times per week for 4-12 weeks

.

Is chiropractor waste of money?

To be precise, the 2012 Medicare data reveals that

in 2012, Medicare paid $496 million for chiropractic treatments in all 50 states

. This is a stunning amount. It dwarfs the funding that NIH wastes on alternative medicine through NCCAM, which is itself an egregious waste of money. Chiropractors are not medical doctors.

Carlos Perez
Author
Carlos Perez
Carlos Perez is an education expert and teacher with over 20 years of experience working with youth. He holds a degree in education and has taught in both public and private schools, as well as in community-based organizations. Carlos is passionate about empowering young people and helping them reach their full potential through education and mentorship.