H.R. 539: Chiropractic Medicare Coverage Modernization Act of 2025

H.R. 539 would make a major change to Medicare's treatment of chiropractors. Today, Medicare recognizes chiropractors in a narrow way and mainly pays for manual manipulation of the spine. This bill would instead recognize a doctor of chiropractic as a physician for any function or action the state legally allows that provider to perform. In plain English, Medicare coverage would no longer be tied to one narrow chiropractic service.

That is a big policy shift because chiropractic scope of practice varies by state. In some states, chiropractors have broader authority than in others. So if this bill became law, Medicare coverage for chiropractic-provided services could expand unevenly across the country, depending on state licensing rules. Supporters argue that this simply updates an old Medicare rule and brings the program closer to how private insurance, the VA, the Defense Department, and other health systems treat chiropractic care.

The bill also adds a condition for payment. For most newly covered chiropractic services, the chiropractor would have to complete a one-time educational documentation webinar or similar electronic training designed by the Secretary of Health and Human Services. But spinal manipulation to correct a subluxation could still be paid without that extra step. That suggests Congress is trying to expand coverage while also putting at least a light guardrail around billing and documentation.

The politics are notable. With more than 150 cosponsors, the bill has real momentum in the House and bipartisan appeal. But opposition is already organized, including from neurosurgery groups, which signals a coming debate over patient safety, evidence standards, and whether Medicare should broaden payment for services delivered by non-MD providers. The biggest practical questions are how much this would cost Medicare, which services would actually qualify in each state, and how aggressively CMS would police billing and scope-of-practice boundaries.