Medicare and spinal decompression: what's covered

What exactly does Medicare cover from a chiropractor?

Spinal adjustments to correct a subluxation, done by hand or with an activator device. Nothing else a chiropractor provides or orders.

Medicare.gov says Part B covers adjustments of the spine by a chiropractor to correct a subluxation, which it describes as when the spinal joints don't move properly but the contact between the joints stays intact, when the chiropractor uses their hands or a device called an activator. Medicare doesn't cover other services or tests a chiropractor orders, including X-rays, massage therapy and acupuncture.

Where does that leave decompression?

Decompression is a separate mechanical service, so under Original Medicare it may not be covered.

For covered services you usually pay a share after the Part B deductible. Current amounts are on Medicare.gov's costs page.

What about Medicare Advantage or a supplement?

Medicare Advantage plans can add benefits; supplements (Medigap) generally help with costs for services Medicare covers.

If you have a Medicare Advantage plan, call the number on your card and ask: Is spinal decompression or mechanical traction covered at a chiropractor? Is prior authorization needed? Is this office in network? A Medigap policy usually only helps with your share of services Original Medicare already covers.

What questions should I ask the office?

Ask what Medicare is expected to pay, what you'd pay, and to see any non-coverage notice before you sign it.

• Which parts of my visits do you expect Medicare to cover?
• What would I pay out of pocket for the full plan?
• Do you need me to sign a notice that a service may not be covered? What does it say?
• What payment options are there?

Is decompression a good idea for older adults?

It can be considered for disc-related pain, but safety screening matters more with age.

Moderate to severe osteoporosis, a recent compression fracture, an aortic aneurysm and some cancers rule it out. Bring your medication list and any bone-density results. Read back pain after 60 and who should not have spinal decompression.

Dr. Gordon Stapel, DC has been in practice since 1993. Call (801) 491-8688 with your Medicare card handy to ask about coverage and cost.

This website is operated for Stapel Family Chiropractic (Springville Disc Center) in Springville, Utah. Care is provided by Dr. Gordon Stapel, DC, a licensed chiropractic physician. About this site.