Insurance & Payment
Here's the honest answer
on insurance.
We accept some insurance plans for standard chiropractic adjustments. Our programs are cash-pay. Here's exactly what's covered, what isn't, and why — so you know before you book.
Questions? Text us at (408) 519-2269 →Quick Reference
Find your situation below.
Landmark or United Healthcare
We accept both plans for standard chiropractic adjustment visits. Call us before your first visit and we'll verify your benefits.
Accepted
PPO Plans (Blue Shield, Anthem, Aetna, Cigna)
We are out-of-network. You pay at the visit and we provide a superbill — many PPO patients get 40–70% back from their insurer.
Superbill provided
HMO, Kaiser, or Medi-Cal
These plans do not cover out-of-network care. You would pay our cash-pay rates directly. Many patients still find our pricing reasonable.
Cash-pay only
Medicare
We are enrolled in Medicare but currently not accepting new Medicare patients. Please call us to discuss your options.
Call to discuss
No insurance
You're in the right place. Flat cash-pay rates, no billing surprises. $90 for your first visit — exam and first treatment included.
Cash-pay welcome
Coverage Details
What insurance actually covers.
Even when we accept your insurance, coverage has limits. Here's exactly what's included and what isn't.
Covered by insurance
For accepted plans — Landmark & UHC
→Chiropractic spinal adjustment (98940, 98941, 98942)
→New patient examination (subject to plan benefits)
→Standard follow-up adjustment visits
Your plan may require a copay, deductible, or coinsurance. We'll verify your benefits before your first visit so there are no surprises.
Not covered by insurance
Cash-pay applies to these services
→Soft tissue therapy (IASTM, cupping, myofascial release)
→Corrective exercise and movement coaching
→Extended visit programs (Restore, Rebuild, Optimize)
→Prepaid visit packages
→Personalized care plan and home exercise program
These services are billed separately at cash-pay rates. HSA and FSA cards are accepted for individual visits at time of service.
PPO Plans
How the superbill process works.
If you have a PPO plan we're not directly contracted with, you can still get reimbursed. Here's how it works step by step.
1
You pay at the visit
You pay our standard rate at the time of service — $180 for a new patient exam, $60 for follow-up adjustments.
2
We provide a superbill
A superbill is a detailed receipt containing all the billing codes, diagnosis codes, and provider information your insurance needs to process a claim. We provide this at no extra charge.
3
You submit to your insurance
You submit the superbill directly to your insurance company — usually online through your member portal or by mail. Most PPO plans make this straightforward.
4
Your insurance reimburses you
Many PPO patients receive 40–70% reimbursement on covered services after their deductible is met. The amount depends on your specific plan's out-of-network benefits. Call your insurer before your first visit to understand what to expect.
Before your first visit: Call the member services number on the back of your insurance card and ask: "What are my out-of-network chiropractic benefits and what is my deductible status?" This takes 5 minutes and tells you exactly what to expect.
Why Cash-Pay
Why our programs are cash-pay.
This is a question we get often and it deserves a straight answer.
Insurance only covers chiropractic manipulation
Under most plans, insurance covers spinal adjustment — and nothing else. Soft tissue therapy, corrective exercise, and movement coaching are explicitly excluded. A program session that includes all three can't be cleanly billed to insurance without splitting it into separate claims — which creates billing complexity, delays, and often still results in denial for the non-adjustment components.
Packages can't be billed to insurance in advance
Insurance reimburses services rendered — not services prepaid. A 12-visit program paid upfront doesn't fit the standard insurance billing model regardless of what's included in each session.
Cash-pay means better care, no restrictions
When care is insurance-driven, visit frequency, treatment type, and duration are all subject to insurer approval. Cash-pay means Dr. Cagape makes clinical decisions based on what's best for you — not what a plan will authorize. Flat rates, no claim denials, no surprise bills.
HSA & FSA
Using your HSA or FSA.
HSA / FSA accepted
→New patient exam — $90 or $180
→Standard adjustment visits — $60
→Extended visits — $85 (paid at time of service)
HSA and FSA funds are accepted for individual visits paid at the time of service. Chiropractic care is a qualified medical expense under IRS guidelines.
HSA / FSA not accepted
→Prepaid visit packages
→Restore, Rebuild, or Optimize programs
HSA and FSA funds cover services at the time they're rendered — not prepaid future services. Packages and programs paid upfront do not qualify under IRS rules.
Medicare
A note on Medicare.
Medicare and chiropractic has some nuances worth understanding.
We are enrolled but not currently accepting new Medicare patients
Dr. Cagape is enrolled in Medicare Part B but is not currently accepting new Medicare patients. If you are a Medicare beneficiary and would like to discuss your options, please call or text us directly.
What Medicare Part B covers for chiropractic
Medicare Part B covers manual spinal manipulation to correct a subluxation — and nothing else performed by a chiropractor. Exams, X-rays, soft tissue work, and exercise are not covered. Medicare pays 80% of the approved amount for covered adjustments after the annual deductible is met.
Important: chiropractors cannot opt out of Medicare
Unlike some other providers, doctors of chiropractic are not permitted to opt out of Medicare under federal law. This means if we treat a Medicare patient for a covered service, we are required to bill Medicare — a patient cannot simply waive Medicare and pay cash for a covered service. This is why we are selective about accepting Medicare patients.
Have Medicare and want to discuss your options? Call or text us at (408) 519-2269 and we'll give you a straight answer about what we can do for you.
FAQ
Insurance questions, answered.
How do I know if my insurance will cover my visit? +
Call the member services number on the back of your insurance card and ask about your chiropractic benefits. Key questions: Do I have chiropractic coverage? Is Modern Movement Chiropractic in-network? What is my deductible and has it been met? What is my copay or coinsurance? You can also call or text us at (408) 519-2269 and we'll help verify your Landmark or UHC benefits before your visit.
Will insurance cover my first visit if I use the $90 new patient special? +
The $90 new patient special is a cash-pay offer only — it cannot be billed to insurance. If you want to use your Landmark or UHC benefits for your new patient exam, the standard rate of $180 applies and we bill your insurance directly.
Can I use my PPO benefits and still enroll in a program? +
You can use your PPO benefits for the chiropractic adjustment component of individual visits and receive a superbill for those. However, program pricing is a bundled cash-pay rate that covers all three services — adjustment, soft tissue, and corrective exercise — and cannot be split for partial insurance reimbursement.
What if I have both Medicare and a supplemental plan (Medigap)? +
Medigap covers the 20% coinsurance that Medicare doesn't cover — but only for services Medicare approves. Since we are not currently accepting new Medicare patients, please call us to discuss your situation before booking.
Do you accept Medicare Advantage (Part C) plans? +
Medicare Advantage plans are administered by private insurers and have their own network rules. We are not currently contracted with any Medicare Advantage plans. Call us to discuss your specific plan and options.
What payment methods do you accept? +
We accept cash, all major credit and debit cards, and HSA/FSA cards for individual visits paid at the time of service. Programs and packages are paid upfront by cash or card — HSA/FSA does not apply to prepaid future services.
I have a question not answered here. +
Call or text us directly at (408) 519-2269 — we'll give you a straight answer. No runaround, no voicemail maze.
Still not sure? Just ask.
Text us your insurance question and we'll respond with a clear answer — usually within a few hours.
Text (408) 519-2269 → or book your $90 new patient exam onlineModern Movement Chiropractic · 133 S. Main St, Milpitas, CA 95035 · (408) 519-2269 · Dr. Daniel Cagape, DC, CPT · California Licensed Chiropractor
