Prior Authorization
Chiropractic Services Requiring Prior Authorization
Under HFS 107.15(3)(a), Wis. Admin. Code, Wisconsin Medicaid requires PA for:
- Services beyond the initial visit and 20 spinal manipulations per spell of illness. If more than 20 manipulations are necessary, the chiropractor should request PA at least four weeks in advance to ensure uninterrupted service.
- Purchase of spinal supports costing more than $75.00.
Prior authorization does not guarantee reimbursement. Provider eligibility, recipient eligibility, and medical status on the date of service, as well as all other requirements, must be met before the claim may be reimbursed.
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Chiropractic Services Handbook
PHC 1306, October 2004