Chiropractic Treatment

A chiropractor may be the treating provider of record for an injured worker. Treatment parameters and prior authorization guidelines are applicable for all chiropractic services, including referrals.

Evaluation and Management Services

Evaluation and management (E&M) services do not require prior authorization, but are reimbursable only when medically necessary to treat a work injury.

Acute/Subacute Chiropractic Care

A chiropractor may provide chiropractic care to treat a work injury without prior authorization during the initial window period of 10 visits or 60 days of care.  All treatment occurring outside of the initial window period requires prior authorization.

Palliative Care

Palliative care may be medically appropriate for an injured worker who has reached maximum medical improvement (MMI).  A request for prior authorization of palliative care must include the completed palliative care questionnaires.

Prior Authorization

Chiropractic Authorization includes detailed information on prior authorization requirements, forms, and submission process.

Resources

The Quick Reference for Chiropractors contains additional information related to chiropractic treatment and authorization requirements.

If a concern arises during treatment of an injured worker, e.g. the injured worker not attending appointments, symptoms not consistent with the injury, cancellation of medical appointments, or noncompliance with treatment plan, contact Customer Service at 701-328-3800 or 800-777-5033.