Page 22 - Medicare Benefit Policy Manual

A. Uniform Minimum Standards

Prior to July 1, 1974

Chiropractors licensed or authorized to practice prior to July 1, 1974, and those
individuals who commenced their studies in a chiropractic college before that date must
meet all of the following three minimum standards to render payable services under the
program:

• Preliminary education equal to the requirements for graduation from an
accredited high school or other secondary school;

• Graduation from a college of chiropractic approved by the State’s chiropractic
examiners that included the completion of a course of study covering a period of
not less than 3 school years of 6 months each year in actual continuous
attendance covering adequate course of study in the subjects of anatomy,
physiology, symptomatology and diagnosis, hygiene and sanitation, chemistry,
histology, pathology, and principles and practice of chiropractic, including
clinical instruction in vertebral palpation, nerve tracing, and adjusting; and

• Passage of an examination prescribed by the State’s chiropractic examiners
covering the subjects listed above.

After June 30, 1974

Individuals commencing their studies in a chiropractic college after June 30, 1974, must
meet all of the above three standards and all of the following additional requirements:

• Satisfactory completion of 2 years of pre-chiropractic study at the college level;

• Satisfactory completion of a 4-year course of 8 months each year (instead of a 3-
year course of 6 months each year) at a college or school of chiropractic that
includes not less than 4,000 hours in the scientific and chiropractic courses
specified in the second bullet under “Prior to July 1, 1974” above, plus courses
in the use and effect of x-ray and chiropractic analysis; and

• The practitioner must be over 21 years of age.

B. Maintenance Therapy

Under the Medicare program, Chiropractic maintenance therapy is not considered to be
medically reasonable or necessary, and is therefore not payable. Maintenance therapy is
defined as a treatment plan that seeks to prevent disease, promote health, and prolong and
enhance the quality of life; or therapy that is performed to maintain or prevent
deterioration of a chronic condition. When further clinical improvement cannot
reasonably be expected from continuous ongoing care, and the chiropractic treatment