Maintenance Care vs. Chiropractic Necessity of Care

Chiropractic Medicare was put together by Chiropractors in 1972-73. They did an excellent job of preserving the Chiropractic principles, even though the Medicare Carriers have done their best to twist it around so they can deal with us like other health care disciplines.

The only service payable for Chiropractic is the reimbursement for the correction of the vertebral subluxation. Not the "treatment" of pain or any other symptoms. For years, the Medicare Carriers have lead us down the "Yellow Brick Road" of treating patients symptoms, so when the symptoms are gone they want us to call the adjustment "maintenance care."

The consumer (our patient) gets cheated when the Chiropractor stops using the "AT" modifier because the patient's symptoms have decreased or are gone, even though they still are being adjusted for the payable service of correcting a vertebral subluxation because they still have subluxations.

The pressure is upon the Doctor of Chiropractic to learn the correct way to "document" the Chiropractic Necessity of Care if there is a vertebral subluxation. Not doing so, cheats the consumer, your patient, from Chiropractic reimbursement. Chiropractic maintenance is a patient that is checked, has NO subluxation, and is NOT adjusted.

When a patient is checked, has a subluxation and is adjusted, that is the primary job we Chiropractors perform and is a payable service in Medicare as long as the doctor "documents" the Chiropractic necessity of care. It is the Doctor of Chiropractic's responsibility to prove the subluxation, "document", and do it all correctly. If we Chiropractors do the job correctly Medicare is an excellent Chiropractic program.