CMS Pub. 100-01, ch. 5, § 70.6

A. General

A licensed chiropractor who meets uniform minimum standards (see subsection C) is a

physician for specified services. Coverage extends only to treatment by means of manual

manipulation of the spine to correct a subluxation demonstrated by X-ray, provided such

treatment is legal in the State where performed. All other services furnished or ordered

by chiropractors are not covered. An X-ray obtained by a chiropractor for his or her own

diagnostic purposes before commencing treatment may suffice for claims documentation

purposes. This means that if a chiropractor orders, takes, or interprets an X-ray to

demonstrate a subluxation of the spine, the X-ray can be used for claims processing

purposes. However, there is no coverage or payment for these services or for any other

diagnostic or therapeutic service ordered or furnished by the chiropractor.

In addition, in performing manual manipulation of the spine, some chiropractors use

manual devices that are hand-held with the thrust of the force of the device being

controlled manually. While such manual manipulation may be covered, there is no

separate payment permitted for use of this device.

B. Licensure and Authorization to Practice

A chiropractor must be licensed or legally authorized to furnish chiropractic services by

the State or jurisdiction in which the services are furnished.

C. Uniform Minimum Standards

l. Prior to July 1, 1974, Chiropractors licensed or authorized to practice prior to July 1,

1974, and those individuals who commenced their studies in a chiropractic college before

that date must meet all of the following minimum standards to render payable services

under the program:

a. Preliminary education equal to the requirements for graduation from an

accredited high school or other secondary school;

b. Graduation from a college of chiropractic approved by the State's chiropractic

examiners that included the completion of a course of study covering a period of not less

than 3 school years of 6 months each year in actual continuous attendance covering

adequate course of study in the subjects of anatomy, physiology, symptomatology and

diagnosis, hygiene and sanitation, chemistry, histology, pathology, and principles and

practice of chiropractic, including clinical instruction in vertebral palpation, nerve tracing

and adjusting; and

c. Passage of an examination prescribed by the State's chiropractic examiners

covering the subjects listed in subsection b.

2. After June 30, 1974 - Individuals commencing their studies in a chiropractic college

after June 30, 1974, must meet all of the following additional requirements:

a. Satisfactory completion of 2 years of pre-chiropractic study at the college level;

b. Satisfactory completion of a 4-year course of 8 months each year (instead of a

3-year course of 6 months each year) at a college or school of chiropractic that includes

not less than 4,000 hours in the scientific and chiropractic courses specified in subsection

1.b, plus courses in the use and effect of X-ray and chiropractic analysis; and

c. The practitioner must be over 21 years of age.