Sponsors (162)
The bill expands Medicare coverage for chiropractic care and aligns benefits with other federal and private payers to improve access and continuity, but it raises federal costs, risks variable state-based coverage and inconsistent care, and adds administrative and implementation challenges that could disrupt access.
Medicare beneficiaries will gain broader access to chiropractic services (as allowed under state law), improving treatment options for pain and musculoskeletal conditions and aligning Medicare coverage with VA/DoD/FEHB and private plans to simplify care continuity.
More licensed chiropractors can furnish payable services and bill Medicare, likely increasing provider participation in Medicare networks and improving patient access, especially in areas with limited providers.
Taxpayers and the Medicare program may benefit from improved program integrity because chiropractors must complete a one-time verification (educational webinar) before Medicare pays for certain services, which could reduce improper billing.
Taxpayers and the Medicare program could face higher spending because expanding Medicare-covered chiropractic services will likely increase program expenditures.
Medicare beneficiaries may face increased risk of inconsistent or unnecessary chiropractic services if medical necessity standards and Medicare billing rules are not clearly defined and enforced.
Beneficiaries could receive unequal coverage for the same condition across states because Medicare coverage would depend on varying state scopes of chiropractic practice.
Based on analysis of 3 sections of legislative text.
Broadens Medicare Part B coverage to any state-authorized chiropractic function and requires a one-time provider verification for payment (except for spinal manipulation for subluxation).
Introduced January 16, 2025 by W. Greg Steube · Last progress January 16, 2025
Expands Medicare Part B recognition and payment for doctors of chiropractic so Medicare will cover any function or action that a state-licensed chiropractor is legally authorized to perform in the state where the service is given. It also adds a payment condition that requires chiropractors to complete a one-time verification (such as attending an educational documentation webinar or updated electronic product) before Medicare will pay for covered chiropractic services, except that manual spinal manipulation to correct a subluxation remains payable without that verification. The change updates Medicare definitions and payment rules to broaden the set of chiropractor-delivered services that qualify as payable “physicians’ services,” while preserving a limited payment pathway for traditional spinal manipulation and adding an administrative verification step for expanded services.