Does Medicare Cover Chiropractic Care? Limits & What to Expect

Many Medicare beneficiaries—and chiropractors—may not realize that Medicare's chiropractic coverage is limited. Medicare Part B only pays for chiropractic services related to manual manipulation of the spine to correct a vertebral subluxation. CMS's own compliance data show that the chiropractic specialty is the highest improper payment specialty at 33.6%. The OIG audit uncovered that Medicare paid for 82% of chiropractic bills that were either unallowable or the bills were being used to pay for maintenance care instead of active treatment. In 2026, you would be responsible for 20% coinsurance, which is paid after the Part B deductible amount of $283. No caps on visits; each visit must show measurable improvement and medical necessity; if not, then becomes a maintenance visit (not covered). The Chiropractic Medicare Coverage Modernization Act of 2025 (H.R. 538/S.106) seeks to make chiropractic an eligible treatment for Medicare beneficiaries by adding exams, X-rays, and other chiropractic services to its coverage, however, it's not yet law.

This article discusses the coverage and benefits of chiropractic care under Medicare, as well as what is included and excluded, the costs involved, and what you can expect to experience in 2026 when visiting a chiropractor. Medicare.gov, CMS, and Chiropractic provider guidelines provide the information. 

What Medicare covers for chiropractic care

Manual manipulation of the spine to correct a vertebral subluxation is covered by Medicare Part B. Medicare definition of subluxation is when the movement of the joints is disrupted but the joints still touch. The chiropractor needs to document the subluxation by physical exam, x-ray (the chiropractor cannot do an x-ray under Medicare) or other method.

Manual manipulation is the process of the chiropractor using controlled force, usually his hands or a small instrument, to correct the misaligned spine. The treatment aim is to actively correct the subluxation and not the patient's condition.

Coverage is based on the usual Part B cost-sharing arrangement: You pay 20% of any Medicare-approved amount, and Medicare pays the rest, after you've used up your Part B deductible of $283. The 20% coinsurance is usually provided by medigap supplement plans.

Medicare does not have any limit on how many times to visit each year. The amount of covered visits is based on medical necessity documentation. Medicare will cover the chiropractic treatment as long as the chiropractor maintains that the treatment is actively working to improve your subluxation with measurable results. Once they move to the maintenance phase of treatment (when they continue to gain but are not being adjusted for subluxation), coverage ends.

Chiropractic Manipulative Treatment (CMT) is coded using 3 codes (98940, 98941, 98942) depending on the number of spinal regions treated, which are based on a 1-2, 3-4, or 5 region coding system. AT modifier (Active Treatment) is needed on claims for each code, signifying that treatment is a correction, not maintenance.

To find out more about Medicare Part B coverage, read our Part B guide. 

What Medicare doesn't cover at chiropractic visits

Medicare doesn't cover as many services as it does for other doctors, so the list of services not covered is longer. Knowing the restrictions will save you unexpected costs.

Your chiropractor's order of x-rays is not covered. This is important since chiropractors frequently request X-rays for confirmation of a diagnosis of subluxation or to exclude other conditions. If you need x-rays prior to chiropractic treatment, they are ordered by your medical doctor (not the chiropractor), and cost is billed by a separate radiology facility. The GY modifier (statutorily excluded service) is commonly seen in the chiropractor's office.

The first chiropractic exam is not included. The first visit to a chiropractor (or after a period of time in which you haven't been treated) establishes your diagnosis and treatment plan for your subluxation(s). This examination is not covered by Medicare even though it's medically necessary for treatment. You get paid at the time the services are rendered, usually $60-$200 per practice.

Even though chiropractors are required to perform reassessment exams between treatment sessions for medical necessity documentation, that is not covered.

When provided in the chiropractic office, massage therapy, acupuncture (Medicare-covered chronic low back pain acupuncture), physical therapy modalities, ultrasound, electrical stimulation, hot/cold therapy, exercise therapy, nutritional counselling and similar adjunctive services are not covered.

Medicare will not pay for extraspinal manipulation (CPT 98943—outside the spine). Treatments should be directed at the joints of the spine.

The coverage excludes maintenance care. When your subluxation is under control and goals for treatment have been met (or once it is no longer measurably improving from chiropractic treatment), maintenance chiropractic care becomes your responsibility. Many beneficiaries discover this when their chiropractor switches them from billing Medicare to billing the patient directly. 

The maintenance care problem

Misclassifying maintenance care as an active treatment is the most common chiropractic billing fraud and audit problem. Active treatment is designed to actively restore subluxation with quantifiable functional improvement. The purpose of maintenance care is to continue to improve the status quo, prevent deterioration or to sustain benefits to health.

Medicare audits review a number of factors to determine if maintenance care is being rendered and documented as active treatment: The same documentation on visits with the same level of pain, treatment notes, and recovery outcomes weeks or months apart; same number of visits or higher that would require special documentation; and visits that are focused more on symptom relief instead of functional improvement.

When your chiropractor indicates that you are “stable” or “maintaining improvement” he or she is saying that you are not getting any worse and that your chiropractic care is not a condition of illness. Medicare does not cover this type of care, which is commonly referred to as maintenance care. The visits are to be designed for ongoing measurable progress towards the functional objectives.

If you have active treatment (one that is covered by Medicare), request that your chiropractor record functional objectives (how far you can walk, how much movement you can achieve, how much pain you can reduce) and track your progress toward them. In most cases when goals are met, subsequent visits become maintenance care. 

Cost breakdown for chiropractic care

Under Original Medicare for chiropractic treatment, your 2026 cost structure works as follows. The $283 annual Part B deductible applies once per year before Medicare starts covering its share. After the deductible, you pay 20% coinsurance of the Medicare-approved amount for covered spinal manipulation.

Medicare-approved amounts for CMT codes 98940-98942 typically range from $25-$65 depending on regions treated and your location. Your 20% coinsurance is therefore $5-$13 per covered visit.

Out-of-pocket costs that don't go through Medicare include the initial chiropractic examination ($60-$200), follow-up examinations ($40-$100), X-rays ($50-$200 if needed), and any non-spinal manipulation or adjunctive services.

For a typical course of care including 1 initial exam ($150 average) and 10-15 spinal manipulation visits (about $90 covered amount each), the total cost structure looks like: deductible $283 + coinsurance $108-$162 + exam $150 = approximately $541-$595 over the treatment course.

Medigap supplement plans cover the 20% coinsurance for covered services, eliminating most out-of-pocket costs beyond the Part B deductible and non-covered services.

Medicare Advantage and chiropractic coverage

Medicare Advantage plans must cover at least the same chiropractic services as Original Medicare. Most plans use copays rather than coinsurance, with typical chiropractic visit copays of $20-$50 per session in 2026.

Some Medicare Advantage plans offer expanded chiropractic benefits as supplemental benefits beyond Original Medicare's coverage. These expanded benefits may include coverage for chiropractic examinations, X-rays, massage therapy, acupuncture, and other adjunctive services. Plan details vary significantly.

Most Medicare Advantage plans require you to use in-network chiropractors. Some require prior authorization for chiropractic services beyond a certain number of visits.

If chiropractic care is important to you, comparing Medicare Advantage plans for chiropractic benefits during the Annual Election Period (October 15-December 7) can identify plans with better coverage than Original Medicare provides.

For Medicare Advantage details, see our MA guide.