07/21/2025
🔴🔵Let's Talk Medicare🔵🔴
One of the most common phone questions our insurance specialist Brenda is asked; “Does Medicare pay for Chiropractic care, and what does it cost?” The short answer is, YES. Medicare Part B covers/reimburses non-maintenance adjustments of the spine. However, under Medicare guidelines, other services like X-rays, exams, and physical therapy are not covered in a chiropractic clinic. According to the Illinois Chiropractic Society, chiropractors are not eligible to opt out of Medicare. Therefore, if a chiropractor in Illinois treats a Medicare patient, they must bill original Medicare or the patient’s Medicare Advantage plan for covered services (spinal adjustments) unless the patient requests for Medicare to not be billed. The fees for clinical services that chiropractors can charge to Medicare patients are also limited by Medicare, and clinic fees cannot legally exceed these limits.
❓True/False❓
“Chiropractors can just “opt out” of Medicare and continue to see Medicare patients.” This is 100% false. If a chiropractor chooses not to enroll in Medicare, then all Medicare patients must be referred to a chiropractor who is enrolled in Medicare. There are no loopholes for treating Medicare patients and bypassing the rules of Medicare enrollment.
“Chiropractors can charge Medicare patients whatever they want, and if Medicare doesn’t pay, then the patient is responsible for the balance”. Again, this is false. Medicare sets the allowable rates for covered services (spinal adjustments), and chiropractors cannot legally bill, charge, or collect more than that specified amount from the patient under any circumstances. This is for the protection of the patient. It’s unfair and extremely unethical to charge patients more than Medicare allows, or to “deny” their Medicare submission as a provider if they wish to have Medicare billed for their covered services (spinal adjustments).
“Non-Medicare participating chiropractors do not have to bill Medicare.” False, but you probably got that one 😉. If the patient requests Medicare be billed, the chiropractor must bill Medicare for the covered services (spinal adjustment). Chiropractors cannot force their patients to sign any form waiving their Medicare billing rights.
What does all of this mean? It means that not only do we accept Medicare at Liles Chiropractic Clinic, but with just shy of 40 years of patient advocacy and Medicare billing experience with our clinic, Brenda will go above and beyond to make sure that each and every one of our patients is treated fairly and their charges are properly billed to utilize his/her Medicare benefits in accordance with Medicare guidelines. Just one of the services we enjoy providing to our patient base and Northwest Illinois!
