Robichaud Chiropractic
56 Winthrop Street
Concord, MA 01742
(978)3692266
(978)3695205- Fax
www.drrobichaud.com

Dr. Robichaud is a participating provider in the HPHC Network. As such, he agrees to abide by the fee schedule set forth by them. We will submit all your claims to HPHC for processing and payment. Many policies carry with them a deductible and co-payment. When there is a remainder balance due, we have a secure service in place to keep a stored form of payment on file. We can charge this card, and you will receive an email showing payment of an outstanding remainder balance. If you would prefer to receive a paper billing statement in the mail, please let us know.

Most Harvard Pilgrim policies carry a standard chiropractic benefit allowing for 12 visits in a year. Some employers provide an increased number, so it is worth checking your policy.

Harvard Pilgrim reduces the allowed charge for spinal manipulation when it is provided on the same day of service as your initial physical examination. Dr. Robichaud typically likes to treat patients on the first appointment, but is not willing to accept the reduced rate for the spinal manipulation. If you would like to be treated on the initial appointment there will be an additional $50.00 charge which is not covered by HPHC. If you would prefer to wait until the second session for treatment, there is no additional charge.

The 2026 fee schedule is as follows:

New patient examination:	$200.00
Established patient re- examination:	$125.00
Spinal Manipulation (office visit)	$60.00
Attended Ultrasound:	$20.00
Stretching Instruction:	$20.00
Exercise Instruction:	$20.00
Manual soft tissue therapy:	$5.00*
Unattended physiotherapy:	$5.00*
Kinesiotaping:	$5.00*

*- not covered by insurance

I have read the waiver policy, and understand I am responsible for payment of any remainder balances.