NON Par Medicare Provider
EXPLANATION OF NON-COVERED CHIROPRACTIC SERVICES
Medicare requires that you pay a yearly deductible of $185 towards your Part B medical expenses before they will begin paying for covered services. If you have already been treated by other doctors this year, you may apply those bills toward your deductible.
After you have met your deductible, Medicare will reimburse 80% of the “allowable” treatment charges. The only “allowable” treatment charge by a Chiropractor is Manual Manipulation of the Spine. Accordingly to Medicare guidelines, Medicare will only allow Chiropractic treatment that is reasonable and necessary to restore or arrest the patient’s covered condition. Once Medicare determines that further manipulation treatment is not “reasonable or necessary”, you will then be responsible to pay for all of your treatment charges.
Medicare does not require x-rays in order for you to be reimbursed for chiropractic treatment. However, Dr. Rapoff may determine x-rays are necessary to assess your condition. Your primary physician will need to order the x-rays. Medicare does not allow Chiropractors to order x-rays.
In order to determine the extent of your condition, as well as the type of treatment you will need, Dr. Rapoff will examine you prior to the initiation of treatment, and periodically thereafter. Medicare will not reimburse for examination charges and therefore you are responsible for the exam charges at the time of service. Exam charges usually run between $25 and $50 depending on the complexity of the exam.
PHYSICAL THERAPY, SUPPLEMENTS AND SUPPORTS
During the course of your treatment in this office, Dr. Rapoff may determine that certain physical therapy modalities or procedures, or orthopedic supports may be necessary to assist in the treatment of your condition. Medicare will not reimburse for any of these services and therefore you are responsible for these charges at the time of service. Modality charges usually run between $15 and $25 depending on the Modality. Orthopedic supports like back braces are charged at $40.00.