Medicare & Chiropractic Care

Back and neck pain are common as we age. Chiropractic care can help some people move easier and feel better. Here’s what Medicare usually pays for—and what it doesn’t—so you can avoid surprise bills.

1) Quick Basics

  • Original Medicare (Parts A & B) has limited chiropractic coverage.

  • Medicare Advantage (Part C) may add extra benefits. Plans differ.

  • Coverage is mainly for spinal manipulation to fix a spinal subluxation (a bone in your spine out of alignment). It is not for general aches or “maintenance” visits.

2) What’s Covered?

Part B may cover:

  • Manual spinal manipulation when a chiropractor diagnoses a subluxation and treatment is medically necessary.

  • Physical therapy if your doctor orders it (not from the chiropractor’s office).

  • Acupuncture for chronic low back pain only, and only under certain rules.

Part A (hospital) doesn’t cover routine chiropractic visits.

Medicare Advantage (Part C): Some plans help pay for things Original Medicare doesn’t—depends on the plan. Call the number on your card to confirm.

3) What’s Not Covered?

  • General or ongoing “tune-ups”/maintenance care

  • Massage therapy

  • X-rays ordered by a chiropractor (some Advantage plans may cover)

  • Acupuncture for reasons other than chronic low back pain

4) What Will I Pay?

  • With Part B, you usually pay 20% of the Medicare-approved amount for a covered spinal manipulation, after the Part B deductible.

  • Medigap (Supplement) may lower or eliminate that 20%.

  • There’s no fixed yearly visit limit, but each visit must be medically necessary.

5) How to Avoid Surprise Bills (5 easy steps)

  1. Ask first: “Is this visit covered by Medicare?”

  2. Check the provider: Make sure the chiropractor is enrolled in Medicare and accepts assignment.

  3. Get it in writing: A short note stating the diagnosis (subluxation) and why manipulation is medically necessary.

  4. Call your plan (if Part C): Ask if it covers X-rays, therapy, or other services at the chiropractor’s office.

  5. Know the no’s: Massage, maintenance care, and most chiropractor-ordered X-rays aren’t covered by Original Medicare.

6) Simple Examples

  • Covered: You have sudden mid-back pain. The chiropractor finds a subluxation and performs manual manipulation.

  • Not covered: You feel “stiff” and want a routine adjustment every month to “stay aligned.” That’s considered maintenance.

7)  Points to Remember

  • Does your Chiropractor able to bill Medicare  and accepts assignment

  • Is your visit is for a diagnosed subluxation

  • Is your treatment is manual spinal manipulation and medically necessary

  • Services such as  (massage, most X-rays, maintenance) are not covered at a chiropractic office

  • If I have Medicare Advantage my coverage may be different

Bottom Line

Medicare helps pay for medically necessary spinal manipulation to correct a subluxation—not routine or wellness care. Before you’re treated, ask the office to confirm coverage and your out-of-pocket costs.