Senior Affair Magazine (senioraffair.com) covers Medicare coverage details for adults 55 and older. Chiropractic care is one of Medicare’s most misunderstood benefits — many seniors are surprised by unexpected bills when their chiropractor performs services beyond what Medicare covers.

What Medicare Covers for Chiropractic Care

Medicare Part B covers manual manipulation of the spine — and only that — when it is medically necessary to treat subluxation of the spine (a condition where vertebrae are misaligned and causing symptoms). Specifically covered:

• Manual manipulation (adjustment) of the spine to correct subluxation
• Both acute and chronic subluxation conditions are covered
• No annual visit limit — Medicare covers as many visits as medically necessary

What Medicare Does NOT Cover for Chiropractic

This is where many seniors get unexpected bills. Medicare explicitly does NOT cover these services, even when performed by a chiropractor:

• Chiropractic examination or consultation — including initial and follow-up exams
• X-rays taken by a chiropractor
• Massage therapy
• Ultrasound or electrical stimulation treatments
• Maintenance care — visits once your condition has stabilized and is no longer improving
• Acupuncture performed by a chiropractor (unless under a separate Medicare acupuncture benefit)

The maintenance care rule is critical: Once your chiropractor determines your condition has plateaued — meaning continued treatment will only maintain your current level rather than produce further improvement — Medicare stops covering visits. At that point, you’ll pay out-of-pocket unless you have supplemental coverage.

How Much Does Medicare Pay for Chiropractic Visits in 2026?

Cost Component	Amount
Part B deductible (annual)	$257/year (applies to all Part B services)
Medicare pays (after deductible)	80% of Medicare-approved amount
You pay (coinsurance)	20% of Medicare-approved amount
Typical Medicare-approved rate per adjustment	$35–$55 per visit
Your typical cost per covered visit (20%)	$7–$11 per adjustment

Note: Your chiropractor may charge more than Medicare’s approved rate. If they “accept assignment” (agree to Medicare’s rates), you cannot be billed for the difference. If they do NOT accept assignment, they can charge up to 15% above Medicare’s approved rate — meaning higher out-of-pocket costs for you. Always confirm whether your chiropractor accepts Medicare assignment before your first visit.

How to Maximize Your Medicare Chiropractic Coverage

1. Use a Chiropractor Who Accepts Medicare Assignment

Use Medicare’s Physician Compare tool at medicare.gov to find chiropractors who accept Medicare assignment in your area. This ensures you won’t pay more than your 20% coinsurance.

2. Understand the ABN (Advance Beneficiary Notice)

If your chiropractor believes Medicare might not cover a particular service (such as when you’ve reached maintenance care status), they should give you an Advance Beneficiary Notice of Noncoverage (ABN) before providing the service. This notice means you’ll be responsible for payment if Medicare denies the claim. Sign it only if you still want the service and understand you’ll pay.

3. Have Medigap or Medicare Advantage for Copay Coverage

A Medigap Plan G covers your 20% chiropractic coinsurance, meaning your covered visits cost $0 after meeting the Part B deductible. Many Medicare Advantage plans also cover chiropractic at low or no copay. See our guide to best Medicare Supplement plans for options.

Does Medicare Advantage Cover Chiropractic?

All Medicare Advantage plans must cover at minimum what Original Medicare covers — including medically necessary chiropractic manipulation. Many plans also extend chiropractic benefits beyond what Original Medicare provides, such as:

• Lower copays per visit ($0–$20 vs. 20% coinsurance)
• Coverage for additional chiropractic services (exams, X-rays) that Original Medicare doesn’t cover
• Additional annual visits covered beyond the medically necessary threshold

Check your plan’s Evidence of Coverage or call the member services number on your Medicare card for your specific plan’s chiropractic benefits.

Frequently Asked Questions

How many chiropractic visits does Medicare cover per year?

Medicare does not have a set annual limit on covered chiropractic visits. Coverage continues as long as visits are medically necessary to treat subluxation and your condition is actively improving. Once your condition reaches maintenance status, Medicare coverage stops.

Does Medicare cover massage therapy?

No — Medicare does not cover massage therapy, even when ordered by a physician or performed in conjunction with chiropractic care. See our related article on does Medicare cover massage therapy for more details.

Does Medicare cover back pain treatment?

Medicare Part B covers medically necessary chiropractic manipulation for back pain caused by spinal subluxation. Medicare also covers physical therapy, pain management injections, and — if medically necessary — back surgery under the appropriate Medicare part. Medicare Part A covers inpatient surgical procedures, while Part B covers outpatient treatments.

Can a chiropractor order tests covered by Medicare?

Chiropractors cannot order Medicare-covered lab tests or imaging studies. If you need an MRI, X-ray, or blood work related to your back condition, you’ll need a referral from a medical doctor (MD or DO). Tests ordered by a chiropractor alone are not covered by Medicare.