Short answer: Medicare Part B covers manual manipulation of the spine by a chiropractor to correct a vertebral subluxation. Medicare does not cover a broad package of chiropractic care.
Original Medicare coverage
The covered service is manual spinal manipulation for a vertebral subluxation. Medicare describes this as a condition in which spinal joints do not move properly while contact between the joints remains intact. The chiropractor must be enrolled in Medicare and must document the condition and treatment.
Medicare does not cover other services or tests ordered or furnished by a chiropractor as chiropractic services. Examples include X-rays ordered by the chiropractor, massage therapy, acupuncture, maintenance therapy, and manipulation of body areas other than the spine. A separately covered service may be payable when it is ordered and furnished by an eligible Medicare provider under that service’s own rules.
Eligibility and limits
The manipulation must be reasonable and necessary to treat the documented spinal subluxation. Routine maintenance care intended to prevent symptoms rather than correct an active condition is not covered. Medicare does not set a simple annual visit allowance. Claims are evaluated based on medical necessity and documentation.
Costs
After the Part B deductible, you generally pay 20 percent of the Medicare-approved amount for a covered manipulation. You pay the full cost of noncovered services unless another Medicare benefit applies. Ask for an Advance Beneficiary Notice when appropriate if the provider expects Medicare to deny a service.
Medicare Advantage
Medicare Advantage plans must cover the Medicare-covered manipulation benefit. Network, referral, authorization, and visit-management rules may apply. Some plans offer additional chiropractic benefits. Those benefits vary by plan.
What to do next
- Ask which service will be billed and whether it treats a documented spinal subluxation.
- Confirm that the chiropractor is enrolled in Medicare or in your plan’s network.
- Request separate prices for any noncovered tests or therapies.
- Review coverage notices before treatment.
Coverage is determined from the claim, the patient’s eligibility, provider status, and applicable Medicare rules. A provider’s recommendation does not guarantee payment. Before a planned service, ask the provider what will be billed and ask Medicare or the plan whether any coverage review is required.
Sources
Last reviewed: August 2026. Medicare rules and plan benefits can change.