Does Medicare Cover Chiropractic Care?

It’s no secret that aging takes a toll on the body. In middle age and beyond, many people suffer from neck and back pain that restricts movement. For some, chiropractic care helps relieve that pain and gets them back to doing activities they enjoy – without having to rely on medication.

If you’re someone who suffers from back or neck pain and want to try chiropractic care, it’s important to know whether your Medicare plan helps cover that treatment. Medicare Part B does, but only for one service: adjustments of the spine to correct subluxation. Read on to find out more about the ins and outs of Medicare’s chiropractic coverage.

Original Medicare coverage for chiropractor visits

Medicare Part B covers chiropractic care that treats vertebral subluxation. Subluxation happens when your spine is slightly out of alignment or has a restriction of movement. This typically disrupts your nervous system and can be painful.

Though many chiropractors offer a wide range of services to treat subluxation, Original Medicare only covers a manual adjustment performed by hand or with an FDA-cleared activator tool (which delivers a low-force tap to the spine).

To have Medicare Part B pay for chiropractic care, certain conditions have to be met. These are:

• The treatment is given by a licensed chiropractor who accepts Medicare.
• The treatment is medically necessary, which a chiropractor has to document by a physical examination or X-ray (these exams are not covered by Medicare Part B).
• The chiropractor must document that the treatment is actively correcting an acute or chronic subluxation. There is no limit to the number of visits per year as long as the provider can show treatments are medically necessary.
• The chiropractor has to show that the treatment can help you recover or improve your function if you have a chronic condition. Maintenance therapy (used to prevent problems or further deterioration) isn’t covered.

What chiropractic services does Medicare NOT cover?

Medicare strictly covers manual manipulation of your spine. Though your chiropractor will have to do an examination and possibly take X-rays to prove you need care, those services aren’t covered by Part B chiropractic guidelines. Here’s a list of care chiropractors offer that won’t be covered by Original Medicare:

1. New-patient physical examinations and routine re-evaluations.
2. X-rays or diagnostic imaging ordered or performed by a chiropractor (though these services may be covered under Part B if they’re ordered by your regular doctor).
3. Complementary therapies: massage therapy, traction, decompression tables, and nutritional counseling.
4. Maintenance and preventive manipulations once the condition has stabilized.
5. Acupuncture (except when it’s used to treat chronic low back pain per Original Medicare’s guidelines).
6. Physical therapy and treatment for pre-existing conditions like diabetic peripheral neuropathy (though you may be able to have them covered if they’re ordered by a physician).
7. Treatment of anything other than spinal subluxation, like shoulder pain, migraines, or sports-related ankle or knee injuries.

Before a chiropractor performs any services other than spinal manipulation, talk with them about your coverage. Discuss whether the care may be covered by Medicare if performed by your regular doctor, or by the chiropractor if your doctor orders the treatment.

Note: Your chiropractor may ask you to sign a document called the Advance Beneficiary Notice of Noncoverage (ABN). If they anticipate any services they’re providing won’t be covered by Medicare, they’ll have you sign this form to show you agree to receiving the treatment and are liable for any fees Original Medicare doesn’t cover.

How much does chiropractic care cost under Medicare?

Before Original Medicare covers any chiropractic treatment, you’ll have to pay your Part B deductible for the year, which is $283 in 2026.

Once you’ve met your deductible, Medicare pays for 80% of the approved amount, and you’ll pay 20% coinsurance if you see a chiropractor who accepts Medicare assignment. If you haven’t paid anything toward your annual deductible, the fees for your first visits could look like this:

• You pay $200 for the initial consultation and exam (which may include X-rays), which are not covered by Medicare Part B,
• $80 per follow-up adjustment,
• After 3 follow-up adjustments, Medicare would pay $64 per adjustment, and you would be responsible for $16 per visit.

If you’ve already met your deductible for the year, you would pay:

• $200 for the initial consultation and exam,
• $16 for the follow-up visit and each following adjustment.

Does Medicare Supplement (Medigap) cover chiropractic care?

Each Medigap (Medicare Supplement) plan covers chiropractic care differently. Here’s a rundown of how the two most popular types of coverage – Plan G and Plan N – cover these services.

Medigap Plan G – (The most popular plan) pays for your 20% Part B coinsurance for covered adjustments. You’re still responsible for your Part B deductible, but once that is paid, Plan G covers all your coinsurance.

Plan N – After you’ve paid your Part B deductible, Plan N covers your coinsurance, but you’ll have a copay for each visit (up to $20). If you see a chiropractor that does not accept Medicare assignment, they could charge up to 15% more than the Medicare-covered amount. These are called Part B excess charges, and Medigap Plan N does not cover these.

Note: Medigap only pays its part of the bill if Medicare Part B approves and pays the claim first.

Your chiropractic coverage Medicare checklist

Before you visit a chiropractor for back or neck pain, or any other care, you should make sure you understand the potential costs and treatment. Here’s a list of things to do prior to getting an adjustment to ensure that as much of it as possible is paid for by your Medicare plan.

1. Make sure your chiropractor is enrolled in and accepts Medicare assignment (not all of them do).
2. Discuss with your chiropractor which services they want to perform are and aren’t covered by Medicare. You may be able to have those services covered if you receive them from your healthcare provider.
3. Keep track of your symptoms and whether they change in case you need to help prove the treatments are medically necessary.
4. Make sure your chiropractor files the claim with Medicare and ask about payment plans if you anticipate you will owe a lot out of pocket.

If you are having pain and plan to visit a chiropractor, it may be time to choose a plan that covers the out-of-pocket expenses that Plan B doesn’t. Reach out to a United Medicare Advisors agent to help you compare Medigap plans and their chiropractic benefits.