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016.06.2-212.000. Coverage of Chiropractic Services

AR ADC 016.06.2-212.000Arkansas Administrative CodeEffective: July 1, 2022

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 2. Chiropractic Provider Manual (Refs & Annos)
Section 210.000. Program Coverage
Effective: July 1, 2022
Ark. Admin. Code 016.06.2-212.000
016.06.2-212.000. Coverage of Chiropractic Services
Currentness
A. Chiropractic services must be administered by a licensed chiropractor, meeting minimum standards promulgated by the Secretary of Health and Human Services under Title XVIII of the Social Security Act. Manipulation of the spine for the treatment of subluxation is the only chiropractic service covered by Medicaid.
B. Benefits.
1. Benefits are not limited for beneficiaries under twenty-one (21) years of age (in the Child Health Services/Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program), except for the limitations on fetal echography (ultrasound) and fetal non-stress tests.
2. Medicaid covers chiropractic services for beneficiaries twenty-one (21) years of age and older, with a benefit limit of twelve (12) visits per State Fiscal Year (SFY: July 1 through June 30).
3. Two (2) chiropractic X-rays per SFY are covered by Medicaid. However, an X-ray is not required for treatment.
4. Chiropractic X-rays count against the five-hundred-dollar per SFY radiology/other services benefit limit.
Radiology/other services include without limitation diagnostic X-rays, ultrasounds, and electronic monitoring/machine tests, such as electrocardiograms (ECG or EKG).
5. The radiology/other services benefit may be extended when medically necessary (see Section 214.000). All X-rays and documentation must be kept in the beneficiary's medical record for a period of five (5) years for audit purposes. Chiropractic services may be provided in the provider's office, the patient's home, a nursing home, or another appropriate place.
C. For beneficiaries who are eligible for Medicare and Medicaid, see Section I of this manual for additional coinsurance and deductible information. See Section III for instructions on filing joint Medicare/Medicaid claims.

Credits

Eff. Nov. 1, 2006. Amended July 1, 2022.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.2-212.000, AR ADC 016.06.2-212.000
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