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Chiropractic Medicare Billing Coverage: New Bill Would Help Millions

expanding chiropractic medicare billing coverage

As the healthcare industry continues to fight the opioid epidemic and encourage the use of drug-free alternatives to managing pain and other chronic conditions, it’s important to also expand coverage to enable such movements to spread. Particularly, expanding chiropractic Medicare billing coverage is a vital effort to improve access to drug-free alternatives for seniors covered by this government program.

One recent initiative to expand drug-free coverage under Medicare is the Chiropractic Medicare Coverage Modernization Act proposed by New York Congressman Brian Higgins and championed by the American Chiropractic Association. Officially filed as H.R. 2654, this legislation would significantly improve access to chiropractic treatments and other related drug-free services.

A Look at the Chiropractic Medicare Coverage Modernization Act (H.R. 2654)

The Chiropractic Medicare Coverage Modernization Act (HR 2654) would enable patients under Medicare coverage to visit a chiropractor for their comprehensive services. Such services might include manual manipulation of the spine and extremities, evaluation and management of conditions, diagnostic imaging, and the utilization of other non-drug treatments in an effort to combat prescription abuse and fight the opioid epidemic.

Essentially, this bill:

  • Provides patient access to all Medicare-covered benefits as delivered by a chiropractor’s state licensure
  • Categorizes a Doctor of Chiropractic (DC) as a “physician” in Medicare’s programming and thus expand their authority as recognized by Medicare
  • Requires that DCs complete a documentation webinar
  • Has bipartisan support and was introduced by 16 cosponsors from both sides of the political aisle

As a side note, the component regarding completing a documentation webinar means that DCs would be required to participate in a webinar that explains how to include proper documentation for billing Medicare. The medical billing and coding process is rather intricate, so mandating a webinar regarding appropriate documentation for billing Medicare would help inform DCs on the process and, ideally, reduce the number of claims filling inaccurately or incompletely.

Overall, this piece of legislation would grant significantly more access to all services provided by a chiropractor and thus empower chiropractors to treat a new population of patients who are covered by Medicare.

Fighting the opioid epidemic doesn’t happen overnight, nor can it be comprehensively addressed with just a single Act, but every little bit counts. Radically expanding chiropractic Medicare coverage for millions of people is one important step to encouraging drug-free alternatives to pain and ailment management plans.

Current Chiropractic Medicare Billing Coverage

The relationship between chiropractic coverage and Medicare has existed for decades—50 years, in fact.

The field of chiropractic medicine was established in the late 19th-century by Daniel David Palmer; the first chiropractic treatment occurred when Palmer noticed his building’s janitor, who was hard of hearing, had a vertebra out of place. Upon manipulating the vertebra back into place, the janitor’s hearing improved and the rest is history. Manual manipulation of the spine, joints, and holistic body has a long tradition of improving overall health and continues to be a cornerstone alternative to prescription drugs.

Let’s briefly outline the history of chiropractic coverage in relation to federal or national recognition:

  • 1972: Medicare introduces chiropractic coverage under the limited scope of spinal manipulation
  • 1974: Chiropractic treatments are included as part of the Federal Employees Health Benefits Program
  • 1993: Congress passes legislation that includes chiropractic medicine in the US Department of Defense healthcare system
  • 1999: Legislation passes to include chiropractic care in the Veterans Affairs healthcare system
  • 2014: The VA launched a chiropractic residency program, the first of its kind in the country, where chiropractors train alongside their medical counterparts at VA medical systems around the country
  • 2019: H.R. 3654 is introduced to the 116th session of Congress by two New York Congressmen, Brain Higgins and Tom Reed, which would expand coverage of Medicare to include comprehensive services as delivered by a licensed chiropractor; the Bill garners 90 cosponsors but ultimately does not pass before the end of that Congressional session
  • 2021: H.R. 2654 is re-introduced by Brian Higgins to the 117th session of Congress and is presented with 16 bipartisan sponsors, which is promising to the future of the Bill; the legislation is the same as the original H.R. 3654 bill

With support from the ACA and chiropractors around the country, H.R. 2654 has a strong chance to pass in this session of Congress and greatly expand coverage of chiropractic services for millions of patients.

medicare bill would expand chiropractic medicare billing coverage

Benefits of Chiropractic Treatment

Chiropractic treatment has been proven to deliver several benefits, including:

Proven Alternative to Prescription Opioids

A recent study conducted in 2020 examined two groups of more than 100,000 people total between the ages of 18 and 84: one group, who went to their doctor alone for managing their pain, and another group who received primary care and chiropractic care.

The study found that those who visited a chiropractor in addition to their primary physician were less likely to be prescribed opioids to manage their pain—in fact, they had half the risk of being prescribed opioids. These findings are significant because it proves that chiropractic treatment is an effective and safe drug-free alternative to managing chronic pain, temporary ailments, and more.

Reduces Chronic Back Pain

Of the 22 million people who seek chiropractic treatment any given year, nearly 8 million of them are seeking relief from chronic back pain. Whether caused by an athletic injury, a car accident, a muscle strain, or something else, chiropractic treatment is effective at managing chronic back pain.

Improved Range of Motion

Routine, consistent chiropractic treatments result in an improved range of motion. Chiropractic treatment reduces inflammation, aids in blood flow, and ensures that your spine and joints are in their optimal positions to enable smooth movement. Increasing your range of motion means that regular activities require less effort on your part!

Optimize Your Chiropractic Medicare Billing Cycle with Holistic Billing Services!

Medicare’s expansion to further include comprehensive chiropractic care would provide a huge benefit to your chiropractic practice and could bring in a whole new group of potential patients; how exciting! Want to optimize your practice’s revenue cycle? Partner with an expert medical billing firm that has specialized expertise in handling chiropractic billing and Medicare experience.

At Holistic Billing Services, we deal exclusively with holistic healthcare practices that deliver acupuncture, massage therapy, and chiropractic treatments to communities around the country. Whether you have questions on chiropractic insurance billing or other methods to enhance your revenue cycle management, feel free to contact our team today and let us know how we can help your practice today!

March 11, 2022
 - by Antonio Arias, MBA, CHBME
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