Chiropractic Audits by Medicare Are Increasing

Why This Topic Matters

Chiropractic claims are being reviewed closely by Medicare contractors, and documentation problems are a major focus of denials and post-payment audits. Understanding the scope of Medicare coverage and the surrounding compliance environment helps providers prepare for audits and reduce avoidable claim issues.

Article Sections

1. Medicare Audit Trends for Chiropractic Services

   Introduces the audit environment for chiropractic services and discusses the broader federal oversight context. Highlights why the topic is drawing increased attention from Medicare-related reviewers.

2. Improper Payment Findings and Documentation Issues

   Summarizes reported payment error findings and the dominant reasons chiropractic claims are denied. Discusses the role of contractor reviews and the documentation concerns that frequently arise.

3. Medicare Medical Necessity and Chiropractic Coverage

   Explains the Medicare coverage framework for chiropractic care and the general policy limits described in the article. Addresses the distinction between covered and noncovered service categories at a high level.

4. Maintenance Therapy and Related Guidance

   Reviews the article’s discussion of maintenance therapy and related Medicare policy developments. Includes reference to CMS guidance and a federal court settlement cited in the article.

5. Covered Chiropractic Services and Documentation Requirements

   Describes the limited set of chiropractic services discussed as covered under Medicare and the coding framework used to report them. Also covers the article’s emphasis on documentation expectations for these services.