Subluxation in Medicare

Section 1861(r)5, which defines a chiropractor as a physician, is the foundation upon which chiropractors are included in the Medicare system.

It states:   “(5) a chiropractor who is licensed as such by the State (or in a State which does not license chiropractors as such, is legally authorized to perform the services of a chiropractor in the jurisdiction in which he performs such services), and who meets uniform minimum standards promulgated by the Secretary, but only for the purpose of sections 1861(s)(1) and 1861(s)(2)(A) and only with respect to treatment by means of manual manipulation of the spine (to correct a subluxation) which he is legally authorized to perform by the State or jurisdiction in which such treatment is provided.”

The specific language, that includes a reference to correcting a subluxation is a two edge sword.  On one hand, the use of the word “only” does restrict the ability of reimbursement policies to  ” …only with respect to treatment by means of manual manipulation of the spine (to correct a subluxation)…”   On the other hand, the reference also serves to define the spinal manipulation as a covered service in the Medicare system.

 

 

 

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