SECTION 354.1052. Authorized Chiropractic Services

(a) Chiropractic services include those services provided by a doctor of chiropractic and which are within the scope of practice of his profession as defined by state law. Benefits are limited to services which consist of necessary treatment or correction by means of manual manipulation of the spine, by use of hands only, to correct a subluxation to the same extent that such benefits are provided under Part B of Medicare. Benefits are available under this section only for services which are provided during the first 12 visits to any one eligible recipient by a doctor of chiropractic during any one benefit period. Benefit period for purposes of this section means a 12 consecutive month period which begins with the month of the first treatment.

(b) Coverage does not extend to the diagnostic, therapeutic services, or adjunctive therapies furnished by a chiropractor or by others under his or her orders or direction. This exclusion applies to the x-ray taken for the purpose of determining the existence of a subluxation of the spine. Additionally, braces or supports, even though ordered by an MD or DO and supplied by a chiropractor, are not reimbursable items.

Source Note: The provisions of this §354.1052 adopted to be effective May 30, 1977, 2 TexReg 1929; amended to be effective April 19, 1978, 3 TexReg 1302; amended to be effective September 1, 1986, 11 TexReg 3648; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; amended to be effective January 10, 2001, 26 TexReg 199; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective September 1, 2003, 28 TexReg 7286; amended to be effective October 1, 2005, 30 TexReg 6041