Chiropractic Demonstration Ended March 31, 2007
All providers should be aware that the Chiropractic Demonstration, which has been in place since April 1, 2005, ended on March 31, 2007.
When the demonstration ends, no other diagnostic or therapeutic service furnished by a chiropractor or under the chiropractor's order will be covered. This means that if a chiropractor orders, takes, or interprets an x-ray, or any other diagnostic test, the x-ray or other diagnostic test can be used for claims processing purposes, but Medicare coverage and payment are not available for those services. This prohibition does not affect the coverage of x-rays or other diagnostic tests furnished by other practitioners under the program. For example, an x-ray or any diagnostic test taken for the purpose of determining or demonstrating the existence of a subluxation of the spine is a diagnostic x-ray test covered under §1861(s)(3) of the Act if ordered, taken, and interpreted by a physician who is a doctor of medicine or osteopathy. Additionally, chiropractors may not certify or recertify plans of care for therapy services.
If you have a patient receiving ongoing care referred or ordered by a chiropractor on or after April 1, 2007, you should know that your services will not be covered by Medicare unless a physician or other nonphysician practitioner (other than a chiropractor) takes over the responsibility as the referring or ordering provider. Please remember that any provider that is noted as the referring or ordering provider must have seen the patient and maintain documentation that the referred or ordered services are medically necessary and appropriate for the individual patient.
Page Last Updated: Monday, 09-Jun-2008 13:34:39 CDT
