“That disparity did not merely harm providers; it harmed patients, particularly those with complex spinal conditions requiring ongoing chiropractic care.”
IN JUNE 2025, NEVADA GOVERNOR JOE LOMBARDO signed into law a landmark Division of Insurance regulatory statute change that corrects decades of inequity in how chiropractic physicians are treated under Nevada insurance law.
The reform updates NRS 689A.049 and NRS 689B.039 and eliminates the statutory cap on the number of treatments a patient may receive from a chiropractic physician. It also requires true parity in reimbursement for chiropractic doctors billing CPT codes within their licensed scope of practice. Simply put, when a chiropractic physician, MD, or DO performs the same covered service, insurers must pay them equally.
This victory was nearly eight years in the making, and its story is one of persistence, coalition-building, and unwavering commitment to patient access. It is also a roadmap for Medicare modernization, demonstrating how state-level reform can serve as a model for federal change.
In 2017, the Nevada Chiropractic Council/Nevada Chiropractic Association (NCC/NCA) formed the Chiropractic Parity Committee in response to growing frustration from both patients and providers. Chiropractic physicians across the state were reporting that their patients were hitting arbitrary visit caps — often as low as six visits annually — regardless of medical/chiropractic necessity. At the same time, CPT codes billed by chiropractic doctors were prejudicially reimbursed at lower rates than those billed by MDs and DOs, even when identical services were rendered.
That disparity did not merely harm providers; it harmed patients, particularly those with complex spinal conditions requiring ongoing chiropractic care. The committee’s first step was a deep legal and statutory review, identifying that the discriminatory language resided directly in NRS 689A.049 and 689B.039.
From 2018 to 2020, the NCC/NCA Parity Committee worked tirelessly to compile research, patient case studies, and economic analyses. We built alliances with patient advocacy groups, physical medicine specialists, and even some forward-thinking insurers.
Importantly, we reframed the issue as a matter of patient rights, not as a matter of professional privilege. Our message was simple: Nevada patients deserve access to the full range of evidence-based chiropractic care without artificial visit barriers or financial discrimination.
Early attempts at reform met resistance in Carson City. Some lawmakers, lobbyists, and insurers expressed concerns over potential cost increases, despite data showing that unrestricted chiropractic care often reduces downstream costs such as surgeries, advanced imaging, and deadly chronic opioid use.
In 2021 and 2023 sessions, proposed reforms failed to advance beyond committee hearings. While disappointing, those setbacks emboldened Nevada chiropractic physicians and clarified the need for broader bipartisan engagement and a stronger emphasis on the role of chiropractic physicians in Nevada’s public health landscape.
During these years, the NCC/NCA began developing relationships with key legislative leaders, including Assembly Speaker Steve Yeager and Assemblywoman Elaine Marzola, chair of the Assembly Commerce and Labor Committee. Their willingness to listen, ask tough questions, and understand the inequities in the system would later prove pivotal.
By 2024, the national conversation around opioid reduction and cost-effective neuromusculoskeletal care gave new urgency to our cause. The NCC/NCA and its Parity Committee presented compelling testimony supported by utilization data, cost comparisons, and patient safety outcomes.
We underscored that Nevada’s outdated statutory caps were out of step with modem evidence and with how other licensed providers were regulated and treated. With increased public awareness, bipartisan interest, and the quiet but steady support of Speaker Yeager and Chair Marzola, momentum shifted in our favor.
In the spring 2025 legislative session, the corrected statutory language was reintroduced. This tune, the bill advanced through committee and passed both chambers, with the final vote count being Assembly 42-0 in favor and Senate 21-0 in favor. In June 2025, Governor Lombardo signed the bill into law.
The success of this legislation was due in no small part to the leadership of Assembly Speaker Yeager and Committee Chair Marzola, whose commitment to eliminating prejudicial practices and championing fairness in healthcare access ensured the bill’s passage. Their ability to build consensus and maintain focus on patient rights was pivotal in turning chiropractic parity from a long-standing aspiration into reality.
The reform achieved two critical changes:
• Elimination of Treatment/Visit Caps - Patients can now receive care from a chiropractic physician based on medical necessity, not arbitrary numbers.
• True Parity in Reimbursement - Insurers must pay chiropractic doctors the same rates as MDs and DOs for identical CPT codes within our licensed scope.
This statute change is more than a win for chiropractic physicians. It is a victory for patients, ensuring access to comprehensive, cost-effective, nonpharmaceutical care for spinal and neuromusculoskeletal health.
For Nevada’s chiropractic doctors, it is also a recognition of professional equality. Our training, licensure, and evidence-based practice standards demand respect, and our reimbursement should reflect that.
Finally, this achievement serves as a model for other states. Equity in access and payment is not a privilege; it is a standard that should be nationwide. More importantly, Nevada’s reform provides a framework for federal Medicare modernization.
“Finally, this achievement serves as a model for other states.”
Just as state law once imposed outdated treatment, visit caps, and discriminatory reimbursement, Medicare still restricts chiropractic physicians under a model that fails to reflect the full scope of evidence-based services we provide. Nevada’s success proves that parity is possible and sustainable when fairness, patient access, and healthcare economics are aligned.
As chair of the Chiropractic Parity Committee, I extend my gratitude to the Nevada Chiropractic Council/Nevada Chiropractic Association, our legislative champions, patient advocates, and every chiropractic physician who wrote letters, testified, and stood firm over these eight years.
I want to especially thank Speaker Steve Yeager and Chair Elaine Marzola for their leadership and partnership throughout this journey. Their efforts ensured chiropractic parity became a professional victory and a patient-centered reform.
We now move forward with a renewed commitment to deliver exceptional care, to prove daily the value of chiropractic physicians in our healthcare system, and to support other states — and ultimately Medicare — in their own parity battles.
In Nevada, chiropractic has finally achieved parity under the law. Our patients, our profession, and our future are stronger because of it.
Dr. Jason Jaeger, DC, is Administrative Director of Advanced Spine & Posture, leading integrated physical medicine in Nevada. A CBP®-trained chiropractic doctor, researcher, and inventor of the Universal Tractioning System, he serves as NBCE Vice President, past CBPN President, and educator. He lives in Las Vegas with his wife and two sons. For more information contact Dr. Jaeger at [email protected] or call 208-939-0301.
