Chiropractic Services

20.2 - Chiropractic Services (Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05) Section 1861(r) of the Social Security Act provides the definition of a physician for Medicare coverage purposes, which includes a chiropractor for treatment of manual manipulation of the spine to correct a subluxation. (As a standard Medicare Part B benefit, manual manipulation of the spine to correct a subluxation must be made available to enrollees of cost plans.) The statute specifically references manual manipulation of the spine to correct a subluxation as a physician service. Thus, Medicare cost plan organizations offering cost plans must use physicians, which include chiropractors, to perform this service. They may not use non-physician physical therapists for manual manipulation of the spine to correct a subluxation. Medicare cost plans may continue to use physical therapists to treat enrollees for conditions not requiring physician services as defined in §1861 (r) of the Social Security Act.