Chiropractic Facility Online Application
By the Division of Professional Licensure
About the Facility Application Process
Frequently Asked Questions
How much does the Chiropractic Facility license cost?
The initial application and license cost $300. There is an annual license renewal fee of $150.
It looks like I qualify as a Solo Practitioner, so now what do I do?
If you have walked through the Solo Practice Decision Tool and determined that you are a solo practitioner, then please fill out this form. Please keep the Board apprised of your current information and complete an application if your circumstances change such that you are no longer a solo practitioner.
If we have a Chiropractic Facility license, do all the individual employees have to maintain their professional licenses?
Yes, all individuals must maintain their professional licenses in order to continue to practice.
My wife and I are both chiropractors and we own and operate our practice together. Do we need a Chiropractic Facility license?
Yes. The legislature did not provide an exception for spouses who practice together.
My husband and I are in practice together but neither of us has 4 years of experience. What do we do about identifying a Chiropractor of Record (CHOR)?
You may apply for a waiver of the experience requirement by completing the CHOR Experience Waiver Application (PDF). You should send this Waiver Application in when you send in the rest of the Chiropractic Facility Application materials (i.e., put it in the envelope with your payment and your receipt).
Alternatively, you and your husband may decide to contract with another, more experienced chiropractor who will serve as your CHOR and assist you with your compliance activities.
I currently practice alone, but my son is going to join my practice when he graduates from school. Do we need a Chiropractic Facility license now?
No. You will need the Chiropractic Facility license when your son joins your practice, but not until then.
I share an office with one other chiropractor. I usually work Mondays, Wednesdays and Fridays and she works Tuesdays, Thursdays and Saturdays. Do we need a Chiropractic Facility license?
It depends – read on.
Maybe not: If the two of you are separate business entities; have separate tax i.d. numbers, different business names and stationery; and use different systems or locations to store your records, then you are probably two solo practices which happen to have the same address.
Maybe: If, on the other hand, you share a business name, stationery, administrative staff, and record storage facilities, you would look more like a partnership and may need a Chiropractic Facility license.
Yes: In particular, if you bill under the same tax i.d. number, routinely cover for each other’s patients, or often switch around your days so that both of you are in the office at the same time, you need a Chiropractic Facility license.
Suggestion: View your arrangement from the patients’ perspective. Do your patients think this is one practice with two doctors or two different practices?
What about subletting part of the office? Does it make a difference if the person subletting is a DC, PT, or massage therapist?
If the person subletting is not a chiropractor, you should be able to determine whether you need a Chiropractic Facility License by working your way through the Solo Practice Decision Tool. If the person subletting is a chiropractor, review the question/ answer immediately preceding this.
I have owned a practice for fourteen years, but I kept the name of the originating doctor on the letterhead, i.e. "Smith-Jones Chiropractic." Jones is the sole proprietor. Am I at risk of being flagged for scrutiny every year?
Possibly, but demonstrating that yours is a solo practice shouldn’t be too difficult. You will need to show the Board that the practice is, in fact, owned and operated by one licensed chiropractor who does not employ any other chiropractors. (For more information about independent contractors and covering doctors, see below.)
I set up my HMO contracts as a “group” because I assumed in 5-10 years I would add another doctor, but I am the only doctor in the practice and I own 100% of the corporation. Does this qualify as a solo exception?
It sounds as if the one chiropractor would qualify for the solo exception. To be sure, please review the Solo Practice Decision Tool.
What if I choose to hire an independent contractor, DC?
If the independent chiropractor works in the business for 26 or more business days per calendar year, then it is no longer considered a solo practice and a Chiropractic Facility license is required.
Is it 26 calendar days or 26 work days?
It is 26 work days – and this includes partial days.
(It does not mean, for example, that a solo practice can have an independent contractor cover for 50 half-days per year. If another chiropractor works there 26 days or more, then a Chiropractic Facility license is required.)
What if the chiropractor is disabled or goes on maternity/ paternity leave?
If a chiropractor in solo practice arranges for another chiropractor to “cover” the practice during a period of disability or maternity/paternity leave (i.e., the covering chiropractor works in the solo practitioner’s office), then the time periods are somewhat extended. Sixty days of coverage per calendar year are permitted for disability and 120 days for maternity/paternity leave. Also, the total of all the days of “coverage” cannot exceed 120 days per year. Of course, the regulations absolutely allow a practice to arrange additional coverage – they just require the office to get a Chiropractic Facility license if coverage exceeds these limits.
What happens in a group practice if the Chiropractor of Record is on vacation, sick, injured, or on maternity leave?
Just as the CEO of a corporation is still the CEO when s/he is on vacation, the Chiropractor of Record is still the Chiropractor of Record when s/he is on vacation or otherwise out of the office. Obviously, the Chiropractor of Record should appropriately delegate her/his responsibilities during short absences. And if the Chiropractor of Record determines s/he will be out for an extended period, then a new (or interim) Chiropractor of Record should be named.
If you are an employee (DC) in a multi-office group, does each office specify a DC as the Chiropractor of Record? Does each office need an application or can a group of doctors/ offices pay one fee?
- Yes, each office must have a Chiropractor of Record.
- Chiropractic Facility licenses are issued for each particular office location. If the group has four locations, for example, then four Chiropractic Facility licenses will be required.
- If a group of offices are located in the same building but are not a group practice, then each may need a separate Chiropractic Facility license. To be sure, please review the Solo Practice Decision Tool and the office-sharing question, above.
Does a one-doctor facility have to be licensed if it is incorporated?
To determine if a facility qualifies as a solo practice (and therefore does not need to be licensed), you should walk through the Solo Practice Decision Tool.
Can a non-chiropractor own an office and employ a chiropractor?
Yes, a non-chiropractor is permitted to own an office and employ a chiropractor. In this arrangement, however, the office would definitely need a Chiropractic Facility license, because the chiropractor does not own 51% of the business.
What happens when a DC dies and a non-DC spouse inherits the practice or facility?
If there is a change in controlling ownership, the facility will need to apply for a new license. Also, if the chiropractor/ owner was also the Chiropractor of Record, the practice would need to name a new Chiropractor of Record.
How does charging us a licensing fee control fraud? Where is the connection? This just looks like a money-maker for the state.
As a stand-alone measure, licensure of Chiropractic Facilities cannot solve the state’s problem of auto insurance fraud. It does, however, give the state some additional, powerful tools to prosecute and curb fraud. Elements of the new law that will help tremendously include:
- A Chiropractor who has had his license suspended for one year or more for fraud then commits another violation can lose his right to practice in the state and to own, operate, or otherwise work in a Chiropractic Facility. In some cases, this will likely mean the Facility will be closed.
- Under the Insurance Fraud statute, the state will also license and inspect Physical Therapy Facilities.
- The law allows the state to work more closely with the Auto Insurance Bureau and the Attorney General’s office to identify and investigate suspicious billing practices.
How does the new law affect house calls?
The Board wants to allow average chiropractors to conduct house calls without creating a huge “house-call loophole.” To balance these two considerations, the Board has taken the position that a Chiropractic Facility license is NOT required for chiropractic treatment provided:
- on a limited basis, and
- where no more than 15 percent of the Chiropractic Facility’s annual revenue is generated by off-site chiropractic treatment.
Will licensed facilities have to be inspected in any way? What will you be looking for?
Licensed facilities may be inspected. The inspectors will be looking to see that each facility is following the rules set out in 233 CMR 5.00.
If continuing education certificates are audited by the board and I don’t have mine, what action will be taken by the board?
The Board may take any disciplinary action it deems appropriate for failure to comply with the statutes and regulations – and it considers both the nature of an offense and its frequency. If you do not have proof of continuing education for one audit period, the Board is likely to impose a fine and require you to demonstrate completion within a certain follow-up period (3 – 6 months, e.g.). If you are a repeat offender, you may face more serious consequences, up to and including revocation.
If an office primarily offers chiropractic care but also offers massage therapy services, does it need a Chiropractic Facility license?
It is possible for a chiropractic office with a massage therapist to fall under the solo practice exception. Work through the Solo Practice Decision Tool to determine whether your office needs a Chiropractic Facility License.
What if the additional services are offered in a chiropractic office are provided by a licensed physical therapist?
Again, it is possible for a chiropractic office to fall under the solo practice exception even if a physical therapist works there. Work through the Solo Practice Decision Tool. However, it is likely the practice will need to be licensed as a Physical Therapy Facility (regulations for PT Facility licensure will be passed soon).
The application asks for information about employees - do you really want information about all our employees? Are we supposed to notify the Board every time we hire someone new?
Yes, the Board needs information about all your employees on the application, including those who are not involved in clinical care.
It would be too much of a burden for you and for the Board if you notified us every time you hired or terminated an employee. However, from now on you need to keep a list of all the individuals you employ over the course of the year and provide that list when you renew your Chiropractic Facility license. In most cases, your facility will already be maintaining this information for payroll and tax purposes.