Chiropractic new patient specials, the "$49 exam and X-rays" offers, are one of the most common ways independent chiropractors fill first-visit slots. Patients search "chiropractic new patient specials" about 210 times a month in the US, and advertisers pay about $9.75 a click for it (Google Ads Keyword Planner data via DataForSEO, US, 12-month average to Sep 2026). This guide covers how to design a special, the legal checks most guides skip, and how to tell whether your special produces patients who stay.
Why chiropractic new patient specials are so common
Three features of chiropractic make specials attractive. First-time patients are often nervous about adjustments and unsure what a visit costs. Cash-pay care is common and Medicare covers only spinal manipulation, so price is visible. And a first visit is the moment to present a care plan, so practices see the special as the start of a relationship rather than a one-off sale.
That last point is also the trap. A special that fills the schedule with one-visit bargain hunters costs more than it earns. Design it, check it, and measure it against care-plan starts.
Offer structures: exam, X-rays and a first adjustment
The common structures, from lowest to highest risk:
| Offer | Example | Main issues |
|---|---|---|
| Complimentary consultation | "Free 15-minute consultation" | Usually the simplest; still subject to state "free" rules |
| Reduced-fee first visit | "$59 first visit: consultation and exam" | Usual-fee disclosure; Medicare patients |
| Exam plus X-rays | "$49 exam and X-rays" | X-rays should be clinically indicated, not a marketing default |
| Exam, X-rays and first adjustment | "$79 complete first visit" | Insurance contract and federal program issues multiply |
Build yours in five steps:
- Decide who it's for. Cash-pay adults only, or everyone? Write the eligibility down now.
- Define exactly what's included. List each service. Say "X-rays if clinically indicated" rather than promising imaging to everyone.
- Set the price and record your usual fee for each included service. You'll need both.
- Pick an end date or cap. Open-ended specials become your de facto price.
- Write the fine print (eligibility, exclusions, required statements) before you write the headline.
Medicare, Medicaid and inducement rules to verify with the OIG
Federal health programs bring two sets of rules, and the HHS Office of Inspector General (OIG) writes the regulations for both. OIG's plain-language guide to the fraud and abuse laws (opens in a new tab) summarizes them: remuneration "includes anything of value", penalties under the Anti-Kickback Statute include fines, jail terms and exclusion from federal health programs, and a separate beneficiary inducement statute imposes civil monetary penalties for offering remuneration to Medicare and Medicaid beneficiaries to influence them to use your services.
Beneficiary inducements. OIG can impose civil money penalties on anyone who offers remuneration to a Medicare or Medicaid beneficiary that they know, or should know, is likely to influence the beneficiary to receive care from them (42 CFR 1003.1000 (opens in a new tab)). OIG's definition of remuneration (42 CFR 1003.110 (opens in a new tab)) includes "transfers of items or services for free or for other than fair market value". That fits a free or discounted exam.
Routine copay and deductible waivers. The same definition counts waived copays and deductibles as remuneration. The exception is narrow: the waiver can't be advertised, can't be routine, and must follow a good-faith finding of financial need or failed collection efforts. "We waive your Medicare deductible" in an ad falls outside it, and OIG says plainly that routinely waiving copays could implicate the Anti-Kickback Statute and that you "may not advertise that you will forgive copayments." Verify any waiver practice with counsel.
The Anti-Kickback Statute makes it a crime to offer or pay anything of value to induce federal program business. OIG's safe harbors, the payment practices it won't treat as offenses, are listed in 42 CFR 1001.952 (opens in a new tab).
Why this bites chiropractors in particular: Medicare covers only spinal manipulation to correct a subluxation, and doesn't cover other services or tests a chiropractor orders, including X-rays (opens in a new tab). A free exam and X-ray given to a Medicare patient, followed by Medicare-billed adjustments, is exactly the pattern to review.
State laws can reach further. Many apply to all payers, including cash and commercial insurance, so excluding Medicare patients doesn't end the analysis.
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
Insurance contracts, fee schedules and discounts
Commercial payer contracts can restrict how the fees you bill a plan compare with what you charge cash patients for the same service, and how advertised discounts apply to the plan's members. Terms differ by payer, so read the fee and discount clauses in each contract, or ask the payer's provider relations team, before an insured patient redeems a special.
Federal rules point the same way. OIG can exclude providers that bill Medicare or Medicaid "substantially in excess" of their usual charges (42 CFR 1001.701 (opens in a new tab)). If a discounted price becomes what most patients actually pay, ask counsel how it affects your usual charge.
Some states also regulate the gap directly. Florida makes it grounds for discipline to advertise a fee "different from the fee or charge the licensee submits to third-party payors" for that service (section 460.413(1)(bb) (opens in a new tab)).
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
State 'free or discounted service' disclosure rules
States set their own disclosure requirements. Florida's make a useful example because they're so specific. Under section 456.062 (opens in a new tab), an ad by a licensed chiropractor for a free, discounted or reduced-fee service must include this statement in capital letters clearly distinguishable from the rest of the text:
"THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT."
Florida's chiropractic statute separately requires the ad to state "the usual fee of the licensee" for any service offered free or at a discount (section 460.413(1)(cc) (opens in a new tab)).
Other states use different wording, different required statements or none at all. Look up your own chiropractic board's advertising rules; our overview of state board advertising rules shows where to find them.
The FTC adds a federal baseline for any "free" offer: its small-business advertising guide (opens in a new tab) says offer terms should be disclosed clearly and conspicuously near the advertised price.
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
Landing pages and ads for your special
Never send a special to your homepage. Give it a page that carries every detail the ad can't:
- Headline with the offer and your town.
- What's included and what isn't.
- Your usual fee, where required.
- Eligibility and exclusions.
- Any required state statement, in the format the law demands.
- A short HIPAA-compliant form (name, phone, preferred time) and a tap-to-call button.
Illustrative example (fictional Florida clinic) $59 new patient visit: consultation and exam. Usual fee $145. X-rays only if clinically indicated, billed separately. Offer for cash-pay patients only; not available to Medicare, Medicaid or other federal program beneficiaries. Ends December 31. THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY… [full statutory text]
When you promote your special on Facebook, keep the ad copy about the offer and your location, never about the viewer's pain. For where else to run it, see chiropractic advertising.
If you use Medfy, the offer page lives on your rebuilt website with a HIPAA-compliant form, and Medfy's analytics count calls and form submissions from that page by source. You can check your offer page with the free audit before you spend on ads.
Common mistakes
- Running the same special for years, so it becomes your real price.
- "Free X-rays for everyone" when imaging should depend on clinical need.
- Leaving out the usual fee or state statement because the ad is "too small".
- Letting Medicare patients redeem a special nobody reviewed.
- Measuring redemptions instead of patients who stay.
Measuring specials: redemptions, care-plan starts, cost per patient
Track the special through four numbers, by source:
- Leads: forms and calls mentioning the offer.
- Redemptions: first visits completed.
- Care-plan starts: redeemers who accepted a recommended plan.
- Visit-six retention: redeemers still in care at their sixth visit.
Hypothetical arithmetic $800 in ads and a $90 discount on 20 redeemed visits ($1,800 forgone) produce 8 care-plan starts. Cost per care-plan start: ($800 + $1,800) ÷ 8 = $325. Compare that with full-price patients from search or referrals.
The discount is a real cost, so include it. Our guide to calculate cost per new patient shows the full method. Dentists face similar trade-offs; dental new patient specials is a useful comparison. For the wider strategy, return to chiropractic marketing.
Frequently asked questions
Can chiropractors offer free exams?
In many cases, yes, but the conditions depend on your state and your patients' coverage. Florida, for example, requires the ad to state your usual fee prominently and to carry a capitalized 72-hour right-to-refuse-payment statement. A free exam offered to Medicare or Medicaid patients can count as remuneration under federal inducement rules. Check your board's rules and payer contracts, and confirm with counsel.
Can I offer a new patient special to Medicare patients?
Be careful. Federal rules treat free or below-market services, and advertised copay or deductible waivers, as remuneration to a beneficiary when they're likely to influence where the patient gets covered care. Medicare covers only spinal manipulation to correct a subluxation, so a discounted exam can lead straight into billed care. If you exclude federal program patients, say so in the ad and on the landing page, and have counsel confirm your approach.
What is a good chiropractic new patient special?
A good special is simple, honest and legal where you practice: a reduced-fee first visit that includes a consultation and exam, with X-rays only if clinically indicated, and a clear statement of what's not included. Show your usual fee where required, state eligibility, and send it to a landing page with a short HIPAA-compliant form. Judge it by care-plan starts, not redemptions.
Do new patient specials lead to long-term patients?
Sometimes. Specials lower the barrier to a first visit, but they can also attract bargain hunters who never return. The only way to know is to track it: of the people who redeemed the offer, how many accepted a care plan and how many reached their sixth visit? Compare that with patients who came through search or referrals at full price.