Does Medicare Pay For Chiropractic Back Pain Treatment

804077832222Based on your diagnosis, your doctor may recommend manual therapy, for your back pain. Although manual therapy is primarily performed by some health care providers, such as chiropractors, osteopathic physicians, physical therapists, and even though massage therapists may also perform some deep tissue techniques, your doctor more or less, might refer you specifically to a chiropractor.

What is Manual Therapy
Manual therapy consists of several techniques including, but not limited to, spinal manipulation or mobilization, muscle energy technique, myofascial release, exercise, and soft tissue mobilization or massage.

What is Manipulation or Mobilization
By definition, it’s a progression or continuation of skilled passive movements of joints(you are not actively moving joints, it’s done by the person providing the therapy) and related soft tissues that are applied at varying speeds and amplitudes.

Manipulation is typically considered a localized thrust of high speed, small amplitude therapeutic movement; whereas with mobilization technique no thrust is usually involved.

The general objectives of manipulation and mobilization are to regain pain-free movement and restore function. Based on research, it’s believed that manipulation is an effective treatment option for selected patients with a recent onset of low back pain, specifically, less than 16 days (ASCM’s p.85).

What Chiropractic Services are Covered by Your Health Insurance
If the costs of your health insurance are covered under Medicare, then what I am about to share with you should be considered very important. The fact that not all chiropractic care are covered by Medicare, you might want to know what Chiropractic services are usually eligible for reimbursement under Medicare, before you see a chiropractor for your back pain. This will also help prevent you from having to pay out of pocket for any non-covered additional treatment.

Medicare’s Reimbursement Policy for Chiropractic Care
Medicare will only pay or reimburse for chiropractic services considered active care, such as acute and chronic spinal manipulation. However, they will not reimburse for any services they consider maintenance care. Any treatment that is performed by a chiropractor to maintain or prevent a patient’s chronic condition from getting worse or when further clinical improvement cannot reasonable be expected from continuous ongoing care, Medicare consider this maintenance care. In other words, if in their judgment the care is no longer deemed medically reasonable and necessary, then they won’t provide any reimbursement for these treatments.

For a better understanding of reimbursable spinal manipulation services, this is simply saying that only chiropractic treatment by means of manual manipulation (using the hands only) of the spine to correct a back problem will be illegible for Medicare coverage. Thus, the treatment that’s deemed necessary by the chiropractor to correct a subluxation, treat or improves the patient’s condition, must be in the form of manual manipulation of the spine only. In other words, chiropractor will not receive any additional payment from Medicare for any hand-held or manual devices used for performing manual manipulation, although such devices may be required to help them perform their job.

Chiropractors Will Not be Reimbursed for Medical Equipment Ordered for Patients
It’s okay for Chiropractors to act as suppliers of durable medical equipment(DME) as long as they have obtained a valid supplier number. However, if they are not license suppliers but instead ordered any durable medical equipment for patients, they will not be reimbursed by Medicare.

For further questions and or information on Chiropractic Care reimbursement you may contact the Department of Health and Human Service — Centers for Medicare and Medicaid Services.

 

Work Cited:
1. DEPARTMENMT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services – Fact Sheet

2. American College Of Sports Medicine(ASCM’s)Resources for Clinical Exercise Physiology 2nd ed.

 

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