Medicare and Chiropractic Care: What Patients Should Ask Before Their First Visit
If you have Medicare and you're dealing with back or neck discomfort, one of the first questions is usually, "Will Medicare cover this?" The honest answer is that Medicare covers part of chiropractic care, but not all of it. Knowing the difference before your first visit helps you avoid billing surprises and focus on getting better.
At Bones 4 Life Chiropractic in Gaithersburg, we accept Medicare and believe patients deserve clear answers about coverage before care begins. This guide explains what Medicare typically covers, what it doesn't, and which questions to ask.
What Medicare Part B Covers at the Chiropractor
Medicare Part B covers one specific chiropractic service: manual manipulation of the spine (an adjustment) to correct a subluxation. According to Medicare, a subluxation occurs when spinal joints do not move properly, although contact between them remains intact. The adjustment must be done by hand or with a hand-held instrument. [1, 2]
Once you meet your annual Part B deductible, you typically pay 20% of the Medicare-approved amount for covered adjustments. What you owe may also depend on any supplemental insurance you have and whether the provider accepts assignment. [1, 3]
Medicare expects care to be active and corrective, meaning there should be reasonable expectations of improvement. Medicare billing rules distinguish this type of care from "maintenance" care, which is ongoing care after improvement has plateaued. Medicare does not consider maintenance care medically necessary. [2, 3]
What Medicare Does Not Cover
This is often where patients are surprised. Medicare does not cover additional services or tests that a chiropractor may order or provide, such as X-rays, massage therapy, and acupuncture. According to federal guidelines, only spinal manipulation is covered by Medicare for chiropractic care, excluding any other diagnostic or therapeutic services.
In practice, non-covered services may include:
The new-patient examination and consultation
Soft-tissue therapy and other hands-on treatments beyond the adjustment itself
Therapeutic exercise or rehabilitation services provided by the chiropractor
Imaging ordered by the chiropractor
Bones 4 Life Chiropractic does not take X-rays in the office. If your evaluation suggests imaging is needed, Dr. Murray will refer you to an appropriate provider. Whether that imaging is covered depends on who orders it and on your plan.
What If You Have a Medicare Advantage Plan?
Medicare Advantage (Part C) plans are required to include all medically necessary services covered by Original Medicare, with some plans offering additional benefits. [4] However, Advantage plans typically have their own networks, prior-authorization requirements, visit limits, and copays. As a result, two individuals who both "have Medicare" may experience significantly different out-of-pocket expenses.
When reviewing or changing plans this fall, remember that Medicare Open Enrollment is from October 15 to December 7, with changes becoming effective on January 1. [5] If chiropractic care is important to you, inquire about it before selecting a plan.
Questions to Ask Before Your First Visit
Bring these questions to your insurer, and to our clinic team:
Is my plan Original Medicare, a Medicare Advantage plan, or a supplement? Have your card ready. The name on it tells us a lot.
Have I met my Part B deductible this year? This affects what you pay for the first covered visits.
Does my plan require a referral or prior authorization for chiropractic care? This is more common with Advantage plans.
What will I owe for the exam and other services Medicare doesn't cover? Ask for these costs up front.
Will I be asked to sign an Advance Beneficiary Notice (ABN)? An ABN is a form that tells you before service that Medicare may not pay, so you can decide whether to go ahead. [2, 3]
How will my progress be measured? Since Medicare covers active, corrective care, a clear plan with reassessments benefits you clinically and administratively.
What Research Says About Chiropractic Care for Older Adults
Coverage is only part of the decision. Many patients also want to know whether chiropractic care is a reasonable, safe option at their age.
Research using Medicare claims data offers useful perspective:
Prescription Opioid Reduction: In one study of nearly 56,000 older Medicare beneficiaries with spinal pain, those who received chiropractic care were 56% less likely to fill an opioid prescription in the following year than those who did not. [6]
Safety & Injury Risk: Another Medicare study found that adults aged 66 to 99 had a lower 7-day risk of head, neck, or trunk injury after a chiropractic visit than after a primary-care visit for a similar complaint. [7] The authors noted that risk was higher for people with certain underlying conditions, such as osteoporosis or long-term blood-thinner use. [7]
These are observational studies. They show associations, not proof of cause and effect. They support what good care should look like anyway: a careful history, screening for conditions that call for a modified approach or a referral, and a plan built around the individual.
Clinical guidelines also support conservative, non-drug options. The American College of Physicians recommends that most people with low back pain start with non-drug treatments such as superficial heat, massage, acupuncture, or spinal manipulation, and that people with chronic low back pain consider exercise and other non-drug approaches. [8]
How Bones 4 Life Chiropractic Approaches Medicare Patients
Every new patient at Bones 4 Life Chiropractic begins with a thorough consultation and examination with Dr. Keith Murray. We review your health history, medications, and goals, explain what we find in plain language, and discuss what Medicare is likely to cover before treatment begins. We don't use pre-set packages or high-pressure contracts.
If your symptoms or history suggest you need medical evaluation first, we'll tell you and help coordinate the referral.
Learn more on our Insurance & Billing page and see what to expect on Your First Visit.
Evidence and Clinical Review
This article was reviewed for clinical accuracy by Dr. Keith Murray, licensed chiropractor and founder of Bones 4 Life Chiropractic in Gaithersburg, Maryland. Coverage information reflects Medicare.gov and CMS guidance available in October 2026. Medicare rules and individual plan benefits can change. Always confirm your coverage with Medicare or your plan.
Last reviewed: October 2026
Schedule a New-Patient Visit
Have Medicare and questions about chiropractic care in Gaithersburg? Call (240) 837-8933 or book an appointment online.
References
Centers for Medicare & Medicaid Services. Chiropractic services coverage. Medicare.gov. https://www.medicare.gov/coverage/chiropractic-services
Centers for Medicare & Medicaid Services. Billing and Coding: Chiropractic Services (Article A56273). Medicare Coverage Database. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56273
Centers for Medicare & Medicaid Services. Medicare Chiropractic Services Fact Sheet. https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31862_17/Chiropractic_FactSheet09.18.14.pdf
Centers for Medicare & Medicaid Services. Compare Original Medicare and Medicare Advantage. Medicare.gov. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
Centers for Medicare & Medicaid Services. Open Enrollment. Medicare.gov. https://www.medicare.gov/health-drug-plans/open-enrollment
Whedon JM, Uptmor S, Toler AWJ, Bezdjian S, MacKenzie TA, Kazal LA. Association between chiropractic care and use of prescription opioids among older Medicare beneficiaries with spinal pain: a retrospective observational study. Chiropractic & Manual Therapies. 2022;30:5. doi:10.1186/s12998-022-00415-7
Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66 to 99 years. Spine. 2015;40(4):264–270. doi:10.1097/BRS.0000000000000725
Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514–530. doi:10.7326/M16-2367
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