Spinal Manipulation Services. Coverage shall be provided for Medically Necessary spinal manipulation, evaluation and treatment for the musculoskeletal conditions of the spine when provided by a licensed chiropractor, doctor of osteopathy (D.O.) or other eligible practitioner who is a Contracting Provider. Benefits will not be provided for spinal manipulation services other than for musculoskeletal conditions of the spine. Spinal Manipulation services are limited to Members who are twelve (12) years of age or older. 1. Prior authorization is not required for spinal manipulation services or for any other service provided by the same provider on the same day as these services.
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Sources: Member Contract