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What the Biden-Harris Administration Emergency Regulation Means for YOU

Yesterday, Thursday, November 4, 2021 the Biden-Harris Administration Issued Emergency Regulation Requiring COVID-19 Vaccination for Health Care Workers. Click here if you wish to read that proposed regulation or the Interim final rule with comment period.

Jason Martin, PCA General Counsel, has since reviewed the HHS/ CMS proposed language and has offered the following response:

Background: The Centers for Medicare & Medicaid Services (CMS) establishes health and safety standards, known as the Conditions of Participation, Conditions for Coverage, or Requirements for Participation for 21 types of providers and suppliers, ranging from hospitals to hospices and rural health clinics to long term care facilities (including skilled nursing facilities and nursing facilities, collectively known as nursing homes).


Most of these providers and suppliers are regulated by this interim final rule with comment period (IFC). Specifically, this IFC directly regulates the following providers and suppliers, listed in the numerical order of the relevant CFR sections being revised in this rule:

● Ambulatory Surgical Centers (ASCs) (§ 416.51)

● Hospices (§ 418.60)

● Psychiatric residential treatment facilities (PRTFs) (§ 441.151)

● Programs of All-Inclusive Care for the Elderly (PACE) (§ 460.74)

● Hospitals (acute care hospitals, psychiatric hospitals, hospital swing beds, long term care hospitals, children’s hospitals, transplant centers, cancer hospitals, and rehabilitation hospitals/inpatient rehabilitation facilities) (§ 482.42)

● Long Term Care (LTC) Facilities, including Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), generally referred to as nursing homes (§ 483.80)

● Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) (§ 483.430)

● Home Health Agencies (HHAs) (§ 484.70)

● Comprehensive Outpatient Rehabilitation Facilities (CORFs) (§§ 485.58 and 485.70)

● Critical Access Hospitals (CAHs) (§ 485.640)

● Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services (§ 485.725)

● Community Mental Health Centers (CMHCs) (§ 485.904)

● Home Infusion Therapy (HIT) suppliers (§ 486.525)

● Rural Health Clinics (RHCs)/Federally Qualified Health Centers (FQHCs) (§ 491.8)

● End-Stage Renal Disease (ESRD) Facilities (§ 494.30)


This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above. It does not directly apply to other health care entities, such as physician offices, that are not regulated by CMS. Most states have separate licensing requirements for health care staff and health care providers that would be applicable to physician office staff and other staff in small health care entities that are not subject to vaccination requirements under this IFC

Bottom line is this does not apply to chiropractors in private practice.

2022 ICD-10-CM Updates Effective October 1, 2021

Provided as a courtesy of the PCA

The 2022 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2022. These 2022 ICD-10-CM codes are to be used for discharges occurring from October 1, 2021 through September 30, 2022 and for patient encounters occurring from October 1, 2021 through September 30, 2022.

This year's coding updates that will affect chiropractic claims are listed below:

  • M54.5 Low back pain. Loin pain and Lumbago NOS have been deleted from the description
  • New Code: M54.50 Low back pain, unspecified. This includes Loin pain and Lumbago NOS.
  • New Code: M54.51 Vertebrogenic low back pain, Low back vertebral endplate pain
  • New Code: M54.59 Other low back pain
  • M54.8 Other dorsalgia. Revise low back pain (M54.5) to low back pain (M54.5-)
  • G44.86  Cervicogenic cephalgia  (Code also the associated cervical spine condition, if known. Cervicogenic cephalgia is a secondary code.

Click Here for Full Document Downloads from CMS

*Be sure to send out all your billing up to September 30 due to the updated ICD10 codes above that go into effect on October 1*

 Medicare ABN Changes

Click Here to Read More

Link to the New Form and Instructions

Get a POSTER for your office to promote HR2654 for Medicare

There is QR code to have patients click the link and then send a message to their Reps in seconds. WANT FULL MEDICARE ACCESS to exams x-rays therapies and to be able to help your Medicare fixed income patients to not have the out of pocket expenses or have to get their x-ray elsewhere? Well this is how you do it! Sample of 1 of 6 versions of the poster is shown, pick the one that "speaks" to you.

Courtesy of Dr. Dennis J. Fitterer, PCA Member and International Chiropractic Association Representative from Pennsylvania.

By Pennsylvania Chiropractic Association | September 13, 2021

International Chiropractors Association Policy on Health Freedom Click Here To Read More

Read More
Brent Shealer, DC - Pittsburgh, PA 
"I just wanted to chime in quickly and give a  Special shout out to the PCA in this group. Simply put, join! Because of my membership I was recently able to reach out to leadership and get a problem resolved very quickly from the state BPOA when I was getting nowhere with them prior. Also, I've been able to stay on top of a lot of the nonsense that is happening with UPMC/AMI right now among other important issues in changes over the years.  For example, there also working on problems with how terrible Aetna is, meeting with Congressman trying to get equal pay for Chiro's that MD's get paid for the same service (EM codes for example), and still working on the problem with doc's having to direct supervise therapy and rehab.
 I see it said on here often, "does PCA know about this and" or "what is the PCA doing about this" regarding issues. Well, yeah, they do, and frankly for the cost of one adjustment a month ($50)  You can be a member and see your answer to those questions yourself, amongst many other discussion points while being informed. They can't solve every problem, but they do try and work hard on your behalf, member or not. So why not support them? A stronger State association, with more members, carries a lot more weight in matters. Thanks!"
Jeff Snyder, DC - Phoenixville, PA
"The PCA is an absolute for any doctor of chiropractic in the Commonwealth of PA. We know membership is essential in order to have strength in numbers when dealing with issues pertaining to practice and public health issues where we can make a huge impact. The PCA has our back and the backs of the consumer (no pun intended). As a practicing chiropractor, the membership fee is a NO BRAINER! Why would you, as a chiropractor, practice without the largest state association in your back pocket, on speed-dial, so you can manage the issues that come up day to day in practice.
The staff at the home office has never been better. Our executive vice president is cordial, respectful, and a true leader who has years of experience which has helped the association greatly over the past number of years.
I'm thankful for the PCA and what we as an association have accomplished to protect the rights of chiropractors to practice as well as protecting the health of individuals throughout our state."

Ed Kropf, DC - Pittsburgh, PA 

"As a PCA member over 31 years I have been a distant observer of Chiropractic in our state as well as the several factions of philosophy practiced here. As so far as the PCA is viewed, I feel the current system in place is providing the best communication with it's members. PCA has put into place several terrific members and administration that take on the problems from many fronts, report and attempt to correct/improve the position for the future of Chiropractic in our state.

Good job, you all are doing things so very much better, keep it up!!!"

Jeffrey Sklar, DC - Philadelphia, PA 
"In full disclosure, I have been a district director for the PCA for the last 2-3 years. However, I have been a member my entire career. The current leadership of the PCA has more passion and commitment toward protecting all PA chiropractors right to practice and patient accessibility than I have ever experienced. Whether you are a member or not, you have been benefiting from all the efforts of volunteer board members and PCA associates from lobbying to legal.
The level of responsiveness from any direct inquires to the Execs or affiliates(legal, political) has always been unparalleled with Ed Nielson as Executive Director. Whether you are a member or not, you have benefited from battles won by the PCA that may have never crossed your front steps.
The PCA has been a major contributor to my success in practicing in Pennsylvania. I am grateful to serve and more grateful to have such selfless colleagues that freely donate hours and hours of their time for our benefit as Pennsylvania DCs!"
Ladeluca Chiropractic
"The PCA helps chiropractors and I have found they are professional and very reliable. I can call them with specific questions and if they cannot answer then they refer me to the right person."

“I am a retired doctor, who was hit with a $17,000 recoupment request from a Pennsylvania health insurer, TWO years after I retired. As a retired-status member, I immediately contacted the Pennsylvania Chiropractic Association.  PCA’s  staff were responsive and very helpful, including referring me to Mr. Jason Martin, PCA’s General Counsel, for a free legal consultation.

After talking at some length with Mr. Martin, he assisted me with the audit and provided very solid advice. I followed his advice and I was able to resolve the audit with the health insurer without any payment on my part.   I am thrilled with the supportI was given by PCA staff and General Counsel Martin’s legal advice.

Thanks to my membership in PCA, I received very responsive and immediate support for my problem.  Most importantly, my membership in PCA saved me $17,000of my hard-earned money!  Thank you, PCA!”

Lori Kalie, DC - Lancaster, PA 

"I actually sold my practice. About two hours after you posted the ad, I got a call from a doctor who was interested. He officially took over today. I received quite a number of calls about the practice since the ad was up. The service you provide is valuable, and I just wanted to thank you and the PCA for offering this service."

Brian Meenan, DC - Pittsburgh, PA 

"I just started my own practice a couple of months ago. $600 is a bit steep but it is worth it! Charge me monthly, that’d be great."

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