Home Administrative Billing & Reimbursement Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Clarification: New routine chiropractic and podiatry benefits for Medicare Advantage plans in 2016

December 1, 2015

[

For the 2016 AmeriHealth New Jersey Medicare Advantage plans, additional benefits were added to cover up to six routine care visits for both chiropractic and podiatry services. A copayment will apply at each visit. Please note that this added coverage is in addition to the standard Medicare-covered chiropractic and podiatry services, which are detailed below:

  • Medicare-covered chiropractic: Medicare Part B covers manipulation of the spine if medically necessary to correct a subluxation when provided by a chiropractor or other qualified provider.
  • Medicare-covered podiatry: Medicare Part B covers podiatrist services for medically necessary treatment of foot injuries or diseases (like hammer toes, bunion deformities, and heel spurs). Part B generally doesn't cover routine foot care (e.g., cutting or removal of corns and calluses; trimming, cutting, and clipping of nails; or hygienic or other preventive maintenance like cleaning and soaking the feet).
A referral is required for all chiropractic and podiatry services. Copayments will apply at each visit for routine chiropractic and podiatry visits; however, the copayment amount does not count toward the member's maximum out-of-pocket amount.

Prior to rendering these services, be sure to verify coverage using the Eligibility and Benefits Inquiry transaction on the NaviNet® web portal.

NaviNet is a registered trademark of NaviNet, Inc.

]

This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of AmeriHealth, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey.
© 2023 AmeriHealth Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer