Chiropractic Coding & Compliance Alert

Reader Question:

Does Medicare Reimburse Multiple Daily Visits?

Question: In this era of accelerated treatment protocols for faster recovery, some DCs use an intensive care concept of multiple daily visits. How much does Medicare support this in terms of reimbursement of services?

Kansas Subscriber

Answer: As per the Noridian LCD L34009 related to chiropractic services, chiropractors are required to demonstrate improvement “within a reasonable and generally predictable period of time.”

It discusses various conditions and the amount of time one typically expects for the condition to recover. Treatment may be more frequent in the beginning but decrease with time as the patient’s condition improves.

As far as the intensive care concept of treatment goes, as per the DC’s description, the patient may receive treatment as many as four to five times in a day, in the office, or in a ward like room where the patient rests for the day.

That said, however, Medicare would not cover the room or ward fees, and the reimbursement of the services would be limited to only one treatment per day.