Chiropractic Licensing and Certifications: State-by-State Breakdown and Requirements

Whether you are just starting your chiropractic career or have your own clinic, you would surely like to demonstrate your commitment to excellence to your patients. Obtaining a chiropractic certification and license can help you achieve that goal.

A chiropractor license is essential to legally practice chiropractic care, while certification is usually documentation to showcase your expertise and set yourself apart from competitors. State requirements for acquiring these accreditations may vary, but they typically involve completing a chiropractic program, passing board exams, and meeting ongoing educational needs.

This article will examine the different types of chiropractic licenses and certifications, how to obtain them, and a state-by-state breakdown of requirements. Read on to find out more.

Do You Need a License to Be a Chiropractor?

The short answer is yes. You need a license to legally provide chiropractic treatment in the United States. Each state has its own requirements for obtaining a chiropractor license.

Without a valid license, you won’t be able to practice chiropractic care and may face legal consequences, including fines and even imprisonment.

Requirements for Obtaining a Chiropractic License

As mentioned, the requirements for obtaining a chiropractic license vary by state. However, there are generally three main categories:

Education Requirements

The educational requirements for obtaining a chiropractic license are usually the most rigorous. Almost every state requires a degree from an accredited chiropractic program, which typically takes a minimum of four years and up to eight years to complete, such as a Bachelor’s Degree in a related field plus a Doctor of Chiropractic degree.

Note that you should check if your program is accredited by the Council on Chiropractic Education (CCE) before pursuing a degree from a particular institution. Additionally, most states require you to complete continuing education every one to three years. The table below breaks down these educational requirements by state.

Clinical Experience Requirements

In addition to completing an accredited chiropractic program, you also need to have clinical experience to obtain a chiropractor license. The exact requirements may vary by state, but typically you’ll need to complete a certain number of hours of supervised clinical practice. During your clinical practice, which is usually integrated into your chiropractic training course, chiropractors work with real patients and apply the knowledge learned to diagnose and treat them.

NBCE Examinations

The National Board of Chiropractic Examiners (NBCE) examination is mandatory in all states to acquire a chiropractor license. The exam has five sections covering anatomy, diagnosis, and chiropractic techniques. The first four sections – Part I, Part II, Part III, and Part IV – are a prerequisite in all states, while the last section – Physiotherapy – is required in most but not all states.

State Board Exams

Finally, most states require you to pass an additional state board exam to receive a chiropractor’s license. However, Colorado, Kentucky, New York, Rhode Island, and Virginia do not. These exams are specific to each state and test your knowledge of the state’s laws and regulations governing chiropractic practice. Passing the state board exam is the final step, after which you can obtain your license to legally practice chiropractic care in that state.

State-by-State Breakdown of Chiropractic License Requirements

Below, you will find a state-by-state breakdown of some of the chiropractic license requirements, including education requirements and examinations. Please note that this information is not exhaustive.

Your area may have additional requirements, so we suggest visiting your state’s licensing agency for more information.

State	Requirements
Alabama	Bachelor of Science and Doctor of Chiropractic degree Continuing education of 18 hours per year Passage of Alabama Chiropractic Law and Rules exam
Alaska	Two years of liberal arts education and a Doctor of Chiropractic degree Continuing education of 32 hours every two years Passage of Alaska chiropractic exam covering jurisprudence and X-ray safety Passage of NBCE Physiotherapy exam
Arizona	Doctor of Chiropractic degree Continuing education of 12 hours per year Passage of Arizona chiropractic jurisprudence exam
Arkansas	Two years of college education in the field of science and a Doctor of Chiropractic degree Continuing education of 24 hours per year Passage of Arkansas chiropractic ethics and Jurisprudence exam Passage of NBCE Physiotherapy exam
California	Doctor of Chiropractic degree Continuing education of 24 hours per year Passage of CCLE (supervisors and operations X-ray permit exam) Passage of California chiropractic jurisprudence exam
Colorado	Continuing education of 15 hours per year
Connecticut	Minimum 60 semester hours of undergraduate education and Doctor of Chiropractic degree Continuing education of 48 hours every two years Passage of NBCE Physiotherapy exam
Delaware	Doctor of Chiropractic degree Continuing education of 24 hours every two years Passage of NBCE Physiotherapy exam
District of Columbia	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 24 hours every two years Passage of D.C. laws and regulations exam
Florida	Two to four years of undergraduate education and Doctor of Chiropractic degree Continuing education of 40 hours every two years Passage of Florida Laws & Rules Exam Passage of NBCE Physiotherapy exam
Georgia	Two years of college education and a Doctor of Chiropractic degree Continuing education of 20 hours per year Passage of open-book Georgia law exam
Hawaii	60 credits of undergraduate education and a Doctor of Chiropractic degree Continuing education of 20 hours every two years Passage of NBCE Physiotherapy exam
Idaho	Doctor of Chiropractic degree Continuing education of 18 hours per year Passage of NBCE Physiotherapy exam
Illinois	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 150 hours every three years
Indiana	Continuing education of 12 hours per year Passage of Indiana jurisprudence exam Passage of NBCE Physiotherapy exam
Iowa	Doctor of Chiropractic degree and 120 hours of physiotherapy education Continuing education of 40 hours every two years Passage of NBCE Physiotherapy exam
Kansas	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 50 hours every 18 months Passage of NBCE Physiotherapy exam
Kentucky	60 credit hours of undergraduate education and a Doctor of Chiropractic degree Continuing education of 12 hours per year
Louisiana	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 15 hours per year Passage of Louisiana state statutes exam Passage of NBCE Physiotherapy exam
Maine	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 48 hours every two years Passage of NBCE Physiotherapy exam
Maryland	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 48 hours every two years Passage of Maryland jurisprudence exam Passage of NBCE Physiotherapy exam, if chiropractor practices physiotherapy
Massachusetts	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 12 hours per term Passage of Massachusetts jurisprudence exam Passage of NBCE Physiotherapy exam
Michigan	Doctor of Chiropractic degree Continuing education of 30 hours every two years English language proficiency
Minnesota	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 20 hours per year Passage of Minnesota jurisprudence exam Passage of NBCE Physiotherapy exam
Mississippi	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 12 hours per year Passage of Mississippi jurisprudence exam Passage of NBCE Physiotherapy exam
Missouri	Doctor of Chiropractic degree Continuing education of 48 hours every two years Passage of Missouri law exam Passage of NBCE Physiotherapy exam
Montana	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 13 hours per year Passage of Montana jurisprudence exam Passage of NBCE Physiotherapy exam
Nebraska	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 36 hours every two years Passage of Nebraska jurisprudence exam (optional but highly recommended) Passage of NBCE Physiotherapy exam
Nevada	60 credit hours of undergraduate education and a Doctor of Chiropractic degree Continuing education of 36 hours every two years Passage of Nevada law exam Passage of NBCE Physiotherapy exam
New Hampshire	Doctor of Chiropractic degree Continuing education of 20 hours every two years Passage of New Hampshire law and administrative rules exam
New Jersey	Continuing education of 30 hours every two years Passage of New Jersey jurisprudence exam
New Mexico	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 16 hours per year Passage of New Mexico jurisprudence exam Passage of NBCE Physiotherapy exam
New York	60 credit hours of undergraduate education and a Doctor of Chiropractic degree Continuing education of 36 hours every three years
North Carolina	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 18 hours per year Passage of North Carolina jurisprudence exam Passage of NBCE Physiotherapy exam
North Dakota	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 20 hours per year Passage of North Dakota jurisprudence exam Passage of NBCE Physiotherapy exam
Ohio	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 36 hours every two years Passage of Ohio jurisprudence exam Passage of NBCE Physiotherapy exam
Oklahoma	Doctor of Chiropractic degree Continuing education of eight hours per year Passage of Oklahoma jurisprudence exam Passage of NBCE Physiotherapy exam
Oregon	Two years of undergraduate education, 36 hours of minor surgery and proctology studies, and a Doctor of Chiropractic degree Continuing education of 20 hours per year Passage of Oregon state exams on minor surgery, proctology, ethics, jurisprudence, public health, obstetrics, gynecology, and genitourinary Passage of NBCE Physiotherapy exam
Pennsylvania	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 24 hours every two years Passage of NBCE Physiotherapy exam (optional but highly recommended)
Rhode Island	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 60 hours every three years Passage of NBCE Physiotherapy exam (optional but highly recommended)
South Carolina	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 36 hours every two years Passage of South Carolina Ethics and Jurisprudence exam
South Dakota	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 40 hours every two years Passage of South Dakota law exam Meeting with the South Dakota Board of Chiropractic Examiners Passage of NBCE Physiotherapy exam
Tennessee	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 24 hours per year Oral interview with a state board member Passage of NBCE Physiotherapy exam
Texas	90 hours of undergraduate education and a Doctor of Chiropractic degree Continuing education of 32 hours every two years Passage of Texas jurisprudence exam Passage of NBCE Physiotherapy exam
Utah	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 40 hours every two years Passage of Utah chiropractic laws and rules exam Passage of NBCE Physiotherapy exam
Vermont	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 24 hours every two years Passage of Vermont jurisprudence exam Passage of NBCE Physiotherapy exam
Virginia	Doctor of Chiropractic degree Continuing education of 60 hours every two years
Washington	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 25 hours per year Passage of Washington jurisprudence exam
West Virginia	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 18 hours per year Passage of West Virginia oral jurisprudence exam Interview with West Virginia Board of Chiropractic Examiners
Wisconsin	Bachelor’s degree and Doctor of Chiropractic degree Continuing education of 40 hours every two years Passage of Wisconsin jurisprudence exam
Wyoming	Two years of undergraduate education and Doctor of Chiropractic degree Continuing education of 12 hours per year Passage of Wyoming jurisprudence exam Passage of NBCE Physiotherapy exam

The Importance of Maintaining a Chiropractor License

Maintaining a license is of utmost importance for chiropractors for several reasons. Not only does it allow them to practice their profession legally, but it also ensures patients’ safety and upholds professional standards. Here are some of the protections it can ensure:

Legal Protection

Practicing chiropractic care without a license in the United States is illegal. Those who do so may face legal consequences such as a penalty of at least $10,000 for each offense and even imprisonment. Additionally, any chiropractic clinic owner who hires practitioners without a license may also face legal charges.

Patient Safety

Secondly, verifying a chiropractor’s license ensures patient safety. Licensing requirements include completing specific educational requirements and passing exams. And since chiropractors must also fulfill continuing education requirements, this provides that they stay-up-date with the latest developments in chiropractic care. This ongoing education is crucial for maintaining high patient safety standards and minimizing the risk of patient harm or injury.

Professional Standards

Finally, maintaining a chiropractor license upholds professional standards. It symbolizes the chiropractor’s commitment and dedication to providing the highest quality of patient care. It also assures patients they are being treated by a qualified healthcare professional who adheres to ethical and professional standards.

How To Renew a Chiropractor License?

Typically, chiropractors must renew their licenses every one to three years, depending on their state. The specific requirements for renewal may vary by state, but they usually include completing continuing education courses, submitting paperwork for renewal, and paying renewal fees. Be sure to review the renewal requirements for the state you practice in to avoid practicing with an expired or invalid license.

Here are some standard documents you will be asked for chiropractic license renewal:

• Renewal Application. This is the primary document to be submitted that is required in all states. The application typically asks for basic information, such as full name, address, contact information, and license number.
• Continuing Education Documentation. If you have completed continuing education courses and have sufficient credits, you must submit proof of completion issued by the chiropractic board of your state.
• Malpractice Insurance Information. Some states may require malpractice insurance which covers legal expenses if the provider is sued. If this is the case, you should submit your insurance information.
• Background Check. Certain states may also do a background check of criminal history.

Each state’s chiropractic licensing board establishes its renewal fees, which usually range from $50 to $500. If you miss the deadline set by your state, you may be required to pay more.

Chiropractor Certifications

Chiropractor certifications can demonstrate to potential employers the physician’s knowledge and skills necessary for the practice.

In this section, we will look at different types of certifications, the procedures to obtain them, and how they can benefit the practitioner and the clinic.

Types and Requirements

There are several types of certifications for chiropractors, depending on the chiropractic specialty. Each certification requires additional education and training beyond the standard chiropractic curriculum. Here are the most sought-after certifications in different areas of practice:

• Certified Medical Acupuncture Provider (CMAP). Those specializing in acupuncture can get this certification from the American Board of Medical Acupuncture (ABMA). The provider has to be a licensed chiropractor with at least 200 hours of medical acupuncture education and pass a written and oral exam. The certification usually costs between $2,000 and $2,500, including training and exam fees.

• Certified Forensic Chiropractor. The American Board of Forensic Professionals (DABFP) can certify chiropractors working in legal settings. This certification allows you to work with the legal system to provide medical knowledge to court proceedings, as well as evaluate if patients are healthy enough to return to work or active military service. The board requires at least 300 hours of clinical experience in forensic medicine and the passage of a written and oral exam. The total cost, including exam and certification fees, is around $2,500 to $3,000.

• Board-Certified Chiropractic Internist (DABCI). Overseen by the American Chiropractic Association (ACA), this certification grants chiropractors specializing in internal medicine and family care the qualification to work with patients with a broader range of clients with specialized needs. Also, chiropractors with this certification are trained to offer more comprehensive care, such as clinical nutrition, exercise, and acupuncture.
  
  Unlike most other certifications, DABCI is more comprehensive and covers a wide range of chiropractic techniques. Those interested in acquiring a DABCI must complete 300 hours of clinical experience in internal medicine, pass an exam, and complete at least 12 hours of continuing education per year. The DABCI certification program costs approximately $4,500 to $6,000.

• Certified Neurological Chiropractor. The American Chiropractic Neurology Board (ACNB) offers certifications in chiropractic neurology. The provider must complete at least 300 hours of clinical expertise and pass a written and oral exam. You can also obtain sub-certifications in various fields in chiropractic neurology, including vestibular rehabilitation, childhood development disorders, brain injuries and rehabilitation, and neurochemistry and nutrition. Each of these sub-certifications requires the passage of additional examinations. The certification program costs around $6,000, including the cost of the program and the exam.

• Certified Chiropractic Sports Physician (CCSP). This certification is provided by the American Board of Sports Physicians (ABSP) to professionals helping athletes recover from injuries or improve their motion. The certification is awarded upon passing a written and oral exam and completing additional education or a Master’s Degree at an accredited chiropractic college. The certification typically costs between $500 and $3,000.

The Benefits of Having Chiropractor Certifications

Obtaining a chiropractic certification provides significant benefits for practitioners, including:

• Increased Credibility. A certified chiropractor demonstrates to patients and employers that they have completed a rigorous educational program and have met additional competency standards. This can increase your credibility and help build trust with patients.

• Expanded Scope of Practice. Certifications enable you to broaden your scope of practice and offer patients a wider range of care. Depending on the type of certification, you can provide services in acupuncture, massage, or nutrition counseling, which will help you address a broader range of patient needs.

• Enhanced Skills and Knowledge. Certification programs typically require you to go through in-depth training in chiropractic techniques and other relevant subjects. This can help you stay up-to-date with the latest developments in your field and offer high-quality service to patients.

• Better Job Prospects. Many employers prefer to hire certified chiropractors, as it showcases a commitment to excellence in their profession. Therefore, certifications may increase your job prospects and help you secure a position at a reputable clinic.

• Potential for Higher Revenue. Finally, certified chiropractors can aim for higher salaries due to their added experience and skills. The National Library of Medicine reports that, on average, chiropractors with board certifications earn $250,000 yearly as opposed to non-board-certified practitioners who make $150,000.

For chiropractic clinic owners, hiring certified providers can bring similar benefits, such as improving the clinic’s reputation, ensuring higher quality of care, and securing more revenue for the facility. As a result, clinic owners can build a successful chiropractic practice. Moreover, certified chiropractors may require less supervision and training, which can help reduce the clinic’s expenses and improve overall efficiency.