S 106119th CongressIn Committee

Chiropractic Medicare Coverage Modernization Act of 2025

Introduced: Jan 16, 2025

Standard Summary

Comprehensive overview in 1-2 paragraphs

The Chiropractic Medicare Coverage Modernization Act of 2025 would broaden Medicare coverage to include all physicians’ services provided by doctors of chiropractic (DCs) within the scope of their state-licensed practice. It would treat DCs as “physicians” for Medicare purposes when they perform any function or action they are legally authorized to perform in their state, not just the traditional chiropractic services. However, payment under the program would be restricted: Medicare would only pay for these DC-provided services if (a) the DC has completed a Secretary-designed educational verification process (via a webinar or similar electronic training), or (b) the service involves manual manipulation of the spine to correct a subluxation. The bill frames this expansion as bringing Medicare coverage in line with coverage already provided to DCs by VA, DoD, FEHB, and many private plans. In short, the bill aims to recognize chiropractors more broadly as Medicare “physicians” and allow a wider range of chiropractor-delivered services to be covered, but it conditions payment on a specific verification process or on continuing to cover only manual spine manipulation under certain scenarios.

Key Points

1Expands Medicare coverage to include all physicians’ services furnished by doctors of chiropractic within the scope of their license, treating DCs as Medicare “physicians” for these services.
2Defines eligibility criteria for coverage by requiring the DC to be licensed as a doctor of chiropractic or legally authorized to perform the relevant function in the state where the service is provided.
3Introduces a payment limitation: Medicare may pay for DC-provided services only if (1) the DC has completed a Secretary-approved educational verification webinar or similar electronic training, or (2) the service is manual manipulation of the spine to correct a subluxation.
4Requires a Secretary-designed verification process to determine whether a DC has completed the educational documentation webinar for payment eligibility.
5Aligns Medicare coverage for chiropractors with coverage already provided by other federal programs (VA, DoD, FEHB) and many private insurers, while preserving a specific limitation on payment.

Impact Areas

Primary: Medicare beneficiaries who receive chiropractic care and may now access a broader range of chiropractor-delivered services under Medicare, subject to verification requirements.Secondary: Doctors of chiropractic (DCs) and state licensing boards, who would be treated as Medicare “physicians” for covered services and who must meet the new verification requirements to obtain payment.Additional impacts:- Administrative/budgetary: Medicare would implement a Secretary-led verification process (webinars or similar training), adding a new administrative requirement and potential ongoing costs for verification and oversight.- Healthcare practice landscape: Possible changes in how chiropractors bill Medicare and how patients access chiropractic services within Medicare, potentially affecting provider networks and utilization.- Quality and scope considerations: The bill preserves a conservative payment trigger (verification or manual manipulation) that could influence the range of services covered beyond manual spinal manipulation.

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