CMS Proposes Changes to Chiropractic X-Ray Reimbursement

CMS Proposes Changes to Chiropractic X-Ray Reimbursement
July 31, 2007
American Chiropractic Association

CA to Submit Comments, Asks DCs to also Contact Agency

The Centers for Medicare and Medicaid Services (CMS), on July 12, published a proposed rule in the Federal Register that would eliminate patient reimbursement for X-rays taken by a radiologist or other non-treating physician and then used by a doctor of chiropractic. If approved, this proposal would reverse a long-standing policy originally obtained by ACA and could severely hamper the chiropractic profession's ability to care for many Medicare patients.

ÏX-rays, when needed, are integral to the overall chiropractic treatment plan of Medicare patients, and unfortunately in the end, it is the beneficiary who will be negatively affected by this proposed change in coverage. The current X-ray Medicare protocol has served patients well, and there is no clinical reason for this proposed change,Ó said ACA President Richard Brassard, DC. ÏIf doctors of chiropractic are unable to refer patients directly to a radiologist, patients may be required to make additional and unnecessary visits to their primary care providers, significantly driving up the costs of patient care.Ó

The proposed change would specifically eliminate Medicare reimbursement in connection with the referral of a patient by a doctor of chiropractic to a radiologist or other non-treating physician for X-rays; however, doctors of chiropractic will still be able to refer patients back to any treating physician, such as a primary care provider, for needed X-rays.

ACA plans to submit comments on this proposal to CMS prior to the Aug. 31 deadline.

While subluxation need not always be detected by X-ray, it is very often the case that a patient requires an X-ray to rule out any contraindications to chiropractic care or to determine appropriate treatment options. X-rays may also be required to help determine the need for further diagnostic testing, such as an MRI, or for a referral to an appropriate health care specialist.

How Can Doctors of Chiropractic Help?
Individual doctors of chiropractic and chiropractic patients are strongly advised to contact CMS and urge them to abolish the recommendation.

CMS must receive comments on this proposal no later than 5 p.m. EDT on Aug. 31. It is suggested that comments be sent electronically, and any attachments should be in Microsoft Word, Microsoft Excel, or WordPerfect.

When commenting, refer to file code CMS-1385-P. Also, include the caption ÏTechnical CorrectionsÓ at the beginning of your comments.