Services not covered

The department shall not pay for the following chiropractic services which are not covered under the Medical Assistance Program: (1) chiropractic practice does not include the prescription or administration of any medication or drug or the performance of any surgery; (2) x-rays furnished by a practitioner of chiropractic; (3) manipulation of other parts of the body, such as the shoulder, arm or knee, even when for subluxation of the spine; (4) lab work ordered by a practitioner of chiropractic; (5) for information or services provided to a client over the telephone; and (6) for cancelled office visits or appointments not kept.