December 2007

Medicare changes X‑ray rules

The Centers for Medicare and Medicaid Services (CMS) has finalized a proposed rule that will eliminate patient reimbursement for x‑rays referred by a doctor of chiropractic and ordered by a radiologist or other non‑treating physician. The new rule goes into effect Jan. 1, 2008.

The CMS noted that since it previously removed the requirement that subluxation must be demonstrated by an x‑ray, the chiropractic exception that allowed chiropractors to receive reimbursement for diagnostic x‑rays was no longer warranted.

"We do not believe it would be necessary or appropriate to continue to permit payment for an x‑ray ordered by a non‑treating physician when a chiropractor, not the ordering physician, will use that x‑ray," the official statement explained.

The new rule eliminates Medicare patient reimbursement in connection with the referral of a medical patient to a radiologist or other non‑treating physician for x‑rays but does not alter the policy in regards to DCs referring patients to a treating physician, such as a primary care provider, for needed x‑rays.

Opposition to the new rule argued that the change could increase health care costs since DCs would be restricted from referring patients to a radiologist, and instead could be required to send the patient back to a primary care provider.