Excellus BlueCross BlueShield works to ensure that the development of corporate medical policies occurs through an open, collaborative process. We encourage participating providers to become actively involved in medical policy development. Each month, draft policies are available for review and comment here. Providers now have the capability of attaching supporting documentation related to their comments.
The following updated medical policy has been reviewed and was approved on June 24, 2021 by the Medical Policy Committee.
Corporate Medical Policy 10.01.02 - Chiropractic Care has been updated to be consistent with current peer-reviewed literature and professional society recommendations. This updated policy will be effective October 20, 2021.This policy applies to the services of all practitioners and facilities but does not apply to all lines of business. Benefits are contract dependent. Please refer to the medical policy and the member’s subscriber contract.
The Chiropractic Care policy provides updates to the criteria for the following indications:
Changes were made to the medically appropriate criteria for chiropractic care. Chiropractic care is considered not medically necessary as a treatment intervention to restore spinal curves or in treatment of idiopathic scoliosis in an asymptomatic patient. Routine or repeat X-ray use to assess the function or structure of the spine is considered not medically necessary in the absence of red flags or clinical reasons to suspect serious underlying pathology.
Chiropractic care is considered investigational when it is rendered for non-neuromusculoskeletal conditions (e.g., infantile colic, childhood asthma, hypertension, primary dysmenorrhea).
The rationale section of the medical policy provides information related to Excellus BCBS’ change in coverage criteria based on current, peer-reviewed literature. These services are subject to audit and policy updates at Excellus BCBS’ discretion. You can access the individual policies here:
If you have any questions regarding this policy, please contact your Provider Relations representative.
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