Chiropractic Services - Part B Payments for Noncovered Services
Part B pays only for a chiropractor's manual manipulation of the spine to correct a subluxation if there is a neuro-musculoskeletal condition for which such manipulation is appropriate treatment (42 CFR § 410.21(b)). Chiropractic maintenance therapy is not considered to be medically reasonable or necessary and is therefore not payable (Centers for Medicare & Medicaid Services's Medicare Benefit Policy Manual, Pub. No. 10002, Ch. 15, § 30.5B). Prior OIG work identified inappropriate payments for chiropractic services. Medicare will not pay for items or services that are not "reasonable and necessary" (SSA § 1862(a)(1)(A)). We will review Medicare Part B payments for chiropractic services to determine whether such payments were claimed in accordance with Medicare requirements.
|Announced or Revised||Agency||Title||Component||Report Number(s)||Expected Issue Date (FY)|
|Completed||Centers for Medicare & Medicaid Services||Chiropractic Services - Part B Payments for Noncovered Services||Office of Audit Services||A-04-16-07064;
W-00-16-35606; various reviews