Medicare Provision for Reimbursement of Chiropractic Manipulation Services

Chiropractic manipulation services are reimbursable only once per day. This provision can be found in the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication, 100-02, Medicare Benefit Manual Policy, Chapter 15, Section 240.1.5, “reimbursement under Medicare will be limited to not more than one treatment per day” and is also stated in the NGS Local Coverage Determination (LCD): Chiropractic Services (L33613).

NGS has identified claims where a second manipulation service was billed and paid for a single beneficiary for the same date of services. These services were, in most cases, performed by two different providers. As a result, overpayments have been requested for the duplicate service(s).