Medicare guidelines state that it will only pay for chiropractic treatment that is Medically Reasonable or Necessary (defined as treatment that yields a significant improvement in clinical findings and patient functionality).
To you, and in the clinical judgement of your chiropractor, your treatment may be CLINICALLY APPROPRIATE: it may enhance your life, relieve your symptoms, support your health and well-being, or prevent the deterioration of a chronic condition.
But treatment that is CLINICALLY APPROPRIATE may not fit Medicare’s definition of MEDICALLY NECESSARY.
Your chiropractor, by law. must inform Medicare when your care becomes maintenance care, thus clarifying to Medicare that this care is not reimbursable, and you will be responsible for payment.
