Special Notice for Medicare Patients
Dr. Chad Luce and the team at The Chiropractic Place are dedicated to providing you with the best chiropractic healthcare possible, with the goal of you reaching your optimal health and function. For that reason, we will always recommend only the treatment you need for the improvement of your condition and will not make recommendations based on what your insurance policy may or may not cover.
The decision to proceed with care is always up to you, the patient, since your healthcare choices are a personal decision. With that in mind, this notice will help you understand what is covered by Medicare in a chiropractic office (any chiropractic office), and what may be your responsibility.
Medicare covers ONLY spinal adjustments, and only when the provider determines that your case meets Medicare’s specific and stringent requirements of active care and medical necessity. (Please review Local Coverage Determination by clicking on the link below.) All other services that we deliver in our office are excluded or not covered by Medicare. This includes those items listed below:
- Evaluation and Management services (examinations, both new and existing patients)
- Adjustments to areas other than the spine (i.e. extremities)
- Physiotherapy modalities and procedures such as Laser therapy, Manual Therapy, EMS, Ultrasound, or Massage Therapy
- Exercises and Assisted Stretching
- Other medical supplies or procedures not listed which are not considered spinal adjustments
- Maintenance, Wellness, or Elective Care are never a covered service under Medicare
Dr. Luce is a Non-Participating Medicare provider. This means that we extend the Medicare allowable fees to Medicare patients who are under active care. It also means we collect payment from patients at the time of service for active, medically necessary care, and we in turn submit electronic claims to Medicare on the patient’s behalf. Any covered services to be reimbursed are paid directly to the patient. If there is a secondary insurance policy, Medicare will forward the claim to them automatically.
Medicare Replacement policies are NOT the same as traditional Medicare and operate more like HMOs. We do not submit billing for Medicare Replacement policies as those claims do not get sent directly to Medicare.
Care provided to Medicare patients whose condition does not meet the stringent criteria of Medicare’s specific requirements of active care and medical necessity, or care provided to Medicare patients who have graduated from active care into maintenance care, will follow the normal non-Medicare office rates of The Chiropractic Place. These non-active care/non-medical necessity visits are not reimbursable by Medicare and hence are not billable to Medicare.
It is the policy of this office never to turn any patient away from care due to financial circumstances. We offer options to assist you with your financial responsibility and we can explain these options to you in detail.
We are happy to include you among our practice family. Please let us know about any questions you have related to your care at The Chiropractic Place.
To read more about Medicare Local Coverage Determination, click here.