WeVote
Log In

Bill

Bill

SB 225

Chiropractors - As introduced, requires certain insurers to reimburse chiropractic physicians at the same rate as physicians for the same services. - Amends TCA Title 56, Chapter 7 and Title 63.

114th Regular Session (2025-2026) Introduced by Brent Taylor

Requires insurers to reimburse chiropractic services at parity with medical physicians, banning discriminatory codes or methods (July 1, 2025 start).

Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 11, Nays 0 PNV 0
#chiropractors
0
WeVote Research Nonpartisan
Bill Summary · SB 225

Summary of SB 225 (Session 114) – Tennessee

Topic: Chiropractors and Insurance Reimbursement

Jurisdiction: Tennessee

Status: As amended, referred to Senate Finance, Ways, and Means after committee actions (see action history). Original aim: require insurers to reimburse chiropractic physicians at the same rate as physicians for the same services. Amended version clarifies and expands to prohibit discrimination in reimbursement methodologies and coding practices.

1) Purpose and Intent

  • To ensure health insurance entities reimburse chiropractic physicians (licensed under Tennessee law) on a reimbursement basis that is not discriminatory compared with physicians licensed under traditional medical practice.
  • To prevent health insurers from creating chiropractic-specific codes or payment methods that bypass or circumvent reimbursement parity with medical physicians for services within the scope of chiropractic practice.

2) Key Provisions

  • Amends TCA 56-7-2404 to substitute “chiropractic physician” for “chiropractor” in relevant sections and expands definitions accordingly.
  • New subsection (a)(3) prohibits health insurance entities from:
    • Using different reimbursement methodologies for services that are listed in a nationally recognized codebook (e.g., CPT) when the service is within the lawful scope of practice of a chiropractic physician.
    • Discriminating between a chiropractic physician and a physician licensed under title 63, chapters 6 or 9, in the calculation or amount of reimbursement for the same service.
    • Creating chiropractic-specific codes or payment methodologies that are not listed in the nationally recognized codebook used to determine reimbursement.
  • Provisions acknowledge that health insurance entities may still use national uniform relative value units (RVUs) to account for resources used, so long as those methods do not circumvent parity.
  • Definitions:
    • “Health insurance entity” = as defined in § 56-7-109.
    • “Nationally recognized services and procedures code book” = includes, but is not limited to, the AMA CPT code book.
  • Exceptions:
    • The provision does not apply to TennCare (Medicaid) or CoverKids programs.
    • It does not apply to certain Medicaid programs when specified (i.e., TennCare and CoverKids are excluded from the bill’s new parity requirements).
  • Effective date: July 1, 2025.

3) Affected Parties

  • Primary: Health insurers operating in Tennessee that determine reimbursement for services rendered by chiropractic physicians.
  • Chiropractic physicians: Licensed practitioners seeking parity in reimbursement with medical physicians.
  • Medical physicians: See parity requirements when services fall within the scope of chiropractic practice and are listed in the national code book.
  • State programs: TennCare and CoverKids are specifically exempt from these changes.
  • State benefit programs: SGIP (State Group Insurance Program) and state employee/local government plans may be affected in terms of reimbursement methodologies and expenditures (federal and local cost sharing outlined below).

4) Procedural and Timeline Details

  • Effective date: July 1, 2025.
  • Fiscal implications (as amended and summarized by Fiscal Review Committee):
    • State government expenditures (General Fund): approx. $2,777,800 in FY26-27 and subsequent years.
    • Federal expenditures: approx. $303,700 in FY26-27 and subsequent years.
    • Local government mandatory expenditures: approx. $1,880,800 in FY26-27 and subsequent years.
  • Estimated impact:
    • Increased expenditures for the State Group Insurance Program (SGIP) due to alignment of chiropractic payment methodologies with medical physician reimbursements.
    • Estimated SGIP expenditure increase of about $5.49 million in FY26-27 and subsequent years.
    • Corresponding implied increases in state and local premium subsidies, with a portion funded by federal dollars.
  • Revenue/Business impact:
    • Expected increase in chiropractic physicians’ revenue (approximately $5.49 million in FY26-27 and subsequent years) due to higher reimbursement parity.
    • Jobs impact: Not expected to be significant; does not increase the number of chiropractors, but increases revenue per service.

5) Summary of Fiscal Notes

  • The amendments indicate the bill’s core financial effect is higher reimbursement costs for patient services rendered by chiropractic physicians, resulting in increases in SGIP expenditures and associated state/local/federal cost shares.
  • The legislation emphasizes compliance monitoring by the Department of Commerce and Insurance using existing resources.

6) Related Details

  • The amended bill aligns with prior fiscal analyses showing a net increase in state expenditures and local expenditures, with a smaller federal increase.
  • The bill has undergone multiple committee actions since 2025, with amended language clarifying prohibitions on discriminatory reimbursement practices and coding schemes.

This summary provides the substantive content and potential fiscal and practical impacts of SB 225 as amended. If you’d like, I can also compare this bill to current law or provide a side-by-side of key provisions.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.