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DEPARTMENT
OF HEALTH AND HUMAN SERVICES
Date Issued: Revised – January 15, 2002 (Revision of December 14, 1994) Operational Policy Letter #: OPL 2002.023 To: Current M+C Organizations Subject: Manual Manipulation of the Spine to Correct Subluxation--Medicare Coverage Effective Date: January 15, 2002 Implementation Date: January 15, 2002 Operational Policy Question: Which practitioners are authorized by law to perform manual manipulation of the spine to correct a subluxation as a Medicare-covered service? Answer: Section 1861(r) of the Social Security Act provides the definition of a physician for Medicare coverage purposes, which includes a chiropractor for treatment of manual manipulation of the spine to correct a subluxation. (As a standard Medicare Part B benefit, manual manipulation of the spine to correct a subluxation must be made available to enrollees in all Medicare + Choice plans.) The statute specifically references manual manipulation of the spine to correct a subluxation as a physician service. Thus, Medicare+Choice organizations must use physicians, which include chiropractors, to perform this service. They may not use non-physician physical therapists for manual manipulation of the spine to correct a subluxation. Medicare+Choice organizations may continue to use physical therapists to treat enrollees for conditions not requiring physician services as defined in section 1861(r) of the Social Security Act. Contact: CMS Regional Office Managed Care Staff This OPL was prepared by the Center for Beneficiary Choices. |
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