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Chiropractic Billing Guidelines for Medicare

Chiropractic billing guidelines for Medicare

Chiropractic services are covered by Medicare Part B Medical insurance for manual manipulation of the spine only if it is medically necessary to make a correction to a subluxation and will have to be provided by a qualified provider or chiropractor.

 

Eligibility:

  • Anyone with Part B will be covered

 

Original Medicare Costs are that you pay 20% of the amount approved by Medicare and then the Part B deductible applies.

 

Out of pocket costs are that you pay for all services and or test that have been ordered by the chiropractor. This includes massage therapy and X-Rays.

 

Important Note: Talk to your doctor or any other health care provider to find out what the cost is for your specific tests, or any items and services, etc. The amount you owe may vary depending on several things.

 

As an example:

  • Additional insurance you might have
  • The amount your doctor charges
  • If your doctor accepts assignment
  • What type of facility it is
  • What location you receive your tests, items, or services.

 

If additional services are recommended by your care provider or doctor that exceed what Medicare covers as well as anything Medicare does not cover. You may have to pay some if not all of the costs for this. It is very important that you ask a lot of questions and make sure you understand why the recommendations are being made by your doctor and discuss if Medicare will pay for these recommendations.

 

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