Chiropractors sometimes ask if they must bill Medicare, even if they are a “cash” practice in the U.S. The answer is “Absolutely YES.” If you provide care for Medicare patients, even if that care is not covered by Medicare, you must send bills to Medicare. You must send in claim forms for all care you provide (even non-covered care), and you must notify Medicare patients of charges that are not covered (this form is called an “ABN”, or Advance Beneficiary Notification.) Since Medicare limits its payments to a specific number of adjustments each year (no therapies, office visits, or x-rays for chiropractic care), the ABN lets the patient know what is not covered.
You can be a “non-participating” Medicare provider, which means that you accept money from patients and you don’t have to wait for Medicare payments. Since many insurance companies use Medicare status as a basis for their own payments, you should obtain your Medicare provider status as soon as you get your chiropractic license.
