Does Medicare Cover Chiropractic Care? A 2026 Guide

Medicare offers partial coverage for chiropractic services, but understanding the scope and limitations is essential for beneficiaries seeking spinal care. While chiropractic treatment addresses various musculoskeletal issues, Medicare’s coverage focuses narrowly on specific manual adjustments, leaving some services outside the benefit structure.

What Are the Eligibility Rules for Chiropractic Coverage?

Medicare Part B covers chiropractic care under strict conditions. To qualify, the treatment must involve manual manipulation of the spine to correct a subluxation—a partial dislocation or misalignment that can be demonstrated through X-ray or physical examination. The chiropractor must be licensed and enrolled in Medicare, and the service must be considered medically necessary.

Beneficiaries do not need a referral from their primary care physician to see a chiropractor for covered services. However, the chiropractor must document the subluxation and the medical necessity of the treatment in the patient’s records. Medicare does not cover maintenance care, wellness visits, or treatments for conditions unrelated to spinal subluxations.

Additionally, Medicare Advantage plans may offer broader chiropractic benefits than Original Medicare, including coverage for additional visits or supplementary services. Beneficiaries enrolled in these plans should review their specific plan documents to understand their coverage.

How to Access Covered Chiropractic Services

Accessing Medicare-covered chiropractic care begins with finding a qualified provider. Beneficiaries can search for Medicare-enrolled chiropractors through the Medicare website or by contacting Medicare directly. Once a provider is identified, scheduling an initial consultation allows the chiropractor to assess the condition and determine if the treatment meets Medicare’s coverage criteria.

During the first visit, the chiropractor will conduct a physical examination and may order X-rays to confirm the presence of a subluxation. If the condition qualifies, the chiropractor will develop a treatment plan focused on manual spinal manipulation. Beneficiaries should confirm that their chiropractor accepts Medicare assignment, which means the provider agrees to accept the Medicare-approved amount as full payment, reducing out-of-pocket costs.

Medicare processes chiropractic claims like other Part B services. After each visit, the chiropractor submits a claim to Medicare, and the beneficiary receives an Explanation of Benefits detailing what Medicare paid and any remaining patient responsibility.

Potential Out-of-Pocket Costs

Understanding the financial aspects of chiropractic care under Medicare helps beneficiaries budget for treatment. Medicare Part B typically covers 80 percent of the Medicare-approved amount for manual spinal manipulation after the annual deductible is met. Beneficiaries are responsible for the remaining 20 percent, which can vary depending on the provider’s charges and whether they accept assignment.

For 2026, the Medicare Part B deductible is subject to annual adjustments. Once the deductible is satisfied, beneficiaries pay a coinsurance amount for each covered visit. If the chiropractor does not accept assignment, the patient may face higher costs, as the provider can charge up to 15 percent above the Medicare-approved amount.

Services not covered by Medicare, such as X-rays, physical examinations, massage therapy, acupuncture, or nutritional counseling provided by the chiropractor, result in full out-of-pocket expenses. Beneficiaries should discuss costs upfront with their provider to avoid unexpected bills.

Prices, rates, or cost estimates mentioned in this article are based on the latest available information but may change over time. Independent research is advised before making financial decisions.

Documents Medicare May Require

Proper documentation is critical for Medicare to approve chiropractic claims. Chiropractors must maintain detailed records demonstrating the presence of a subluxation and the medical necessity of treatment. This documentation typically includes the initial assessment, physical examination findings, X-ray results if applicable, and a treatment plan outlining the frequency and duration of care.

Medicare may request additional documentation during claims reviews or audits. Chiropractors must provide evidence that the spinal manipulation addresses an acute condition or a documented subluxation rather than general wellness or maintenance care. Beneficiaries should ensure their provider keeps thorough records and submits accurate claims to avoid delays or denials.

If a claim is denied, beneficiaries have the right to appeal. The denial notice will include instructions for filing an appeal, and the chiropractor’s documentation will be essential in supporting the case for coverage.

Alternatives if Coverage is Limited

When Medicare coverage for chiropractic care falls short, several alternatives can help beneficiaries manage costs and access needed treatment. Medicare Advantage plans often include additional chiropractic benefits, such as coverage for more visits, wellness care, or ancillary services like massage therapy. Comparing plans during the Annual Enrollment Period can help beneficiaries find options that better match their healthcare needs.

Medigap supplemental insurance policies can help cover the 20 percent coinsurance for Medicare-approved chiropractic services, reducing out-of-pocket expenses. However, Medigap does not cover services that Original Medicare excludes, such as maintenance care or non-covered therapies.

Some chiropractors offer discounted self-pay rates for services not covered by Medicare. Beneficiaries can inquire about payment plans or package deals that reduce the per-visit cost. Community health centers and nonprofit organizations may also provide low-cost or sliding-scale chiropractic services for those with limited income.

Physical therapy, covered under Medicare Part B when medically necessary and prescribed by a physician, can serve as an alternative or complement to chiropractic care. Physical therapists address musculoskeletal conditions through exercise, manual therapy, and other modalities, and Medicare typically covers 80 percent of approved costs after the deductible.

Medicare coverage for chiropractic care provides valuable support for beneficiaries with spinal subluxations, but understanding the limitations and costs ensures informed decision-making. By verifying provider enrollment, reviewing plan options, and exploring alternatives, beneficiaries can access the care they need while managing expenses effectively.