DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR'S OFFICE  
CHIROPRACTIC - GENERAL RULES  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16145, 16148, 16401, 16412, 16423, and 16431 of the public health  
code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16401, 333.16412, 333.16423, and  
333.16431, and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-  
4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)  
PART 1. GENERAL PROVISIONS  
R 338.12001 Definitions.  
Rule 1. (1) As used in these rules:  
(a) "Adjustment apparatus" means a tool or device used to apply a mechanical force  
to correct or reduce subluxations, misalignments, and joint dysfunctions.  
(b) "Analytical instruments" means instruments used in the detection and diagnosis  
of human conditions and disorders of the human musculoskeletal and nervous systems as  
they relate to subluxations, misalignments, and joint dysfunctions, or to assist the  
chiropractor in offering advice to seek treatment from other health professionals to restore  
and maintain health.  
(c) “Board” means the Michigan board of chiropractic created in section 16421 of  
the code, MCL 333.16421.  
(d) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to  
333.25211.  
(e) “Department” means the department of licensing and regulatory affairs.  
(f) "Nationally recognized standards" means that which is taught in a chiropractic  
educational program or postgraduate educational program accredited by the Council on  
Chiropractic Education (CCE).  
(g) "Physical measures" means procedures or techniques used to correct or reduce  
subluxations, misalignments, and joint dysfunctions.  
(h) "Rehabilitative exercise program" means the coordination of a patient's exercise  
program; the performance, ordering and use of tests; the performance of measurements;  
instruction and consultation; supervision of personnel; and the use of exercise and  
rehabilitative procedures, with or without assistive devices, for the purpose of correcting  
or preventing subluxations, misalignments, and joint dysfunctions.  
(i) "Test" means a procedure that is ordered or performed for the purpose of detecting  
and diagnosing human conditions and disorders of the human musculoskeletal and nervous  
systems as they relate to subluxations, misalignments, and joint dysfunctions, or to assist  
the chiropractor in offering advice to seek treatment from other health professionals to  
restore and maintain health.  
(2) A term defined in the code has the same meaning when used in these rules.  
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History: 1982 AACS; 2006 AACS; 2011 AACS; 2019 AACS; 2022 AACS.  
R 338.12001a Rescinded.  
History: 2016 AACS; 2019 AACS.  
R 338.12002 Rescinded.  
History: 1982 AACS; 1998-2000 AACS; 2011 AACS.  
R 338.12003 Rescinded.  
History: 1982 AACS; 1987 AACS; 1992 AACS; 2000 AACS; 2001 AACS; 2006 AACS; 2011 AACS;  
2019 AACS.  
R 338.12004 Rescinded.  
History: 1982 AACS; 1987 AACS; 1998-2000 AACS; 2011 AACS; 2019 AACS.  
R 338.12005 Rescinded.  
History: 1982 AACS; 1987 AACS; 1998-2000 AACS; 2006 AACS; 2011 AACS; 2019 AACS.  
R 338.12006 Rescinded.  
History: 1982 AACS; 1998-2000 AACS; 2006 AACS; 2011 AACS; 2019 AACS.  
R 338.12007 Rescinded  
History: 1982 AACS; 1998-2000 AACS.  
R 338.12008 Rescinded.  
History: 2006 AACS; 2011 AACS; 2019 AACS.  
R 338.12008a Rescinded.  
History: 1982 AACS; 1987 AACS; 1992 AACS; 1998-2000 AACS; 2006 AACS; 2011 AACS; 2019  
AACS.  
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R 338.12008b Rescinded.  
History: 2011 AACS; 2019 AACS 2019.  
R 338.12009 Rescinded.  
History: 1982 AACS; 2011 AACS; 2014 AACS.  
R 338.12010 Rescinded.  
History: 1982 AACS; 2011 AACS; 2019 AACS.  
R 338.12011 Rescinded.  
History: 1982 AACS; 2011 AACS; 2019 AACS.  
R 338.12011a Rescinded.  
History: 2011 AACS; 2019 AACS.  
R 338.12011b Rescinded.  
History: 2011 AACS; 2019 AACS.  
R 338.12012 Rescinded.  
History: 1982 AACS; 1996 AACS.  
R 338.12013 Rescission.  
Rule 13. R 338.2201 to R 338.2225 and R 338.2241 of the Michigan Administrative  
Code, appearing on pages 2536 and 2537 of the 1979 Michigan Administrative Code, and  
page 135 of Quarterly Supplement No. 5 to the 1979 Michigan Administrative Code, are  
rescinded.  
History: 1982 AACS.  
R 338.12014 Rescinded.  
History: 1987 AACS; 2011 AACS; 2019 AACS.  
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R 338.12015 Rescinded.  
History: 2006 AACS; 2011 AACS; 2019 AACS.  
R 338.12016 Telehealth.  
Rule 16. (1) A licensee shall obtain consent from the patient for treatment before  
providing a telehealth service under section 16284 of the code, MCL 333.16284.  
(2) A licensee shall keep proof of consent for telehealth treatment in the patient’s  
up-to-date medical record and satisfy section 16213 of the code, MCL 333.16213.  
(3) A licensee providing any telehealth service shall do both of the following:  
(a) Act within the scope of the licensee’s practice.  
(b) Exercise the same standard of care applicable to a traditional, in-person health  
care service.  
History: 2025 MR 11, Eff. May 7, 2025.  
PART 2. EDUCATION  
R 338.12021 Educational program standards; adoption by reference.  
Rule 21. (1) The process and requirements for the CCE’s accreditation of chiropractic  
educational programs as set forth in the publication titled "CCE Accreditation Standards:  
Principles, Processes & Requirements for Accreditation" July 2021, which are available  
from the council's website at http://www.cce-usa.org at no cost, are approved and adopted  
by reference. Copies are available for inspection and distribution at a cost of 10 cents per  
page from the Board of Chiropractic, Bureau of Professional Licensing, Department of  
Licensing and Regulatory Affairs, 611 West Ottawa Street, P. O. Box 30670, Lansing,  
Michigan 48909.  
(2) A chiropractic educational program accredited by the CCE is considered approved.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
PART 3. LICENSURE  
R 338.12031 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 31. (1) Under section 16148 of the code, MCL 333.16148, an individual seeking  
licensure or who is licensed shall have completed training in identifying victims of human  
trafficking that satisfies the following standards:  
(a) Training content must cover all the following:  
(i) Understanding the types and venues of human trafficking in the United States.  
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(ii) Identifying victims of human trafficking in healthcare settings.  
(iii) Identifying the warning signs of human trafficking in healthcare settings for  
adults and minors.  
(iv) Identifying resources for reporting the suspected victims of human trafficking.  
(b) Acceptable providers or methods of training include any of the following:  
(i) Training offered by a nationally-recognized or state-recognized health-related  
organization.  
(ii) Training offered by, or in conjunction with, a state or federal agency.  
(iii) Training obtained in an educational program that has been approved for initial  
licensure or registration, or by a college or university.  
(iv) Reading an article related to the identification of victims of human trafficking  
that satisfies the requirements of subdivision (a) of this subrule and is published in a peer-  
reviewed journal, healthcare journal, or professional or scientific journal.  
(c) Acceptable modalities of training may include any of the following:  
(i) Teleconference or online seminar.  
(ii) Online presentation.  
(iii) Live presentation.  
(iv) Printed or electronic media.  
(2) The department may select and audit an individual and request documentation of  
proof of completion of training. If audited by the department, the individual shall provide  
an acceptable proof of completion of training, including either of the following:  
(a) Proof of completion certificate issued by the training provider that includes the  
date, provider name, name of training, and individual’s name.  
(b) A self-certification statement by the individual. The certification statement must  
include the individual’s name and either of the following:  
(i) For training completed under subrule (1)(b)(i) to (iii) of this rule, the date, training  
provider name, and name of training.  
(ii) For training completed under subrule (1)(b)(iv) of this rule, the title of article,  
author, publication name of peer-reviewed journal, healthcare journal, or professional or  
scientific journal, and the date, volume, and issue of publication, as applicable.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
R 338.12032 Educational limited license; requirements.  
Rule 32. An applicant for a nonrenewable educational limited license under section  
16412 of the code, MCL 333.16412, shall satisfy the requirements of the code and the rules  
promulgated under the code, and all the following requirements:  
(a) Provide the required fee and a completed application on a form provided by the  
department.  
(b) Provide proof, as directed by the department, verifying the completion of 2 years  
of education in a college of arts and sciences.  
(c) Provide proof, as directed by the department, verifying the completion of 1 of the  
following requirements:  
(i) Two years of attendance in a program or institution of chiropractic that satisfies  
the educational requirements under R 338.12021.  
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(ii) Four semesters of attendance in a program or institution of chiropractic that  
satisfies the educational requirements under R 338.12021.  
(iii) Six quarter terms of attendance in a program or institution of chiropractic that  
satisfies the educational requirements under R 338.12021.  
(d) Provide proof, as directed by the department, verifying that a licensed chiropractor  
shall supervise the applicant.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
R 338.12033 Examination; adoption and approval; passing score.  
Rule 33. The national board examination in chiropractic conducted and scored by the  
National Board of Chiropractic Examiners (NBCE) is approved and adopted. The passing  
score recommended by the NBCE for the national board examination parts I, II, III, and IV  
is approved and adopted.  
History: 2019 AACS; 2022 AACS.  
R 338.12034 Licensure by examination; requirements.  
Rule 34. An applicant for a chiropractic license by examination shall satisfy the  
requirements of the code and the rules promulgated under the code, and all the following  
requirements:  
(a) Provide the required fee and a completed application on a form provided by the  
department.  
(b) Provide proof, as directed by the department, verifying graduation from a program  
or institution of chiropractic that satisfies the educational requirements under R 338.12021.  
(c) Provide proof, as directed by the department, verifying passing scores on parts I,  
II, III, and IV of the national board examination conducted and scored by the NBCE, under  
R 338.12033.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
R 338.12035 Licensure by endorsement; requirements.  
Rule 35. (1) An applicant for a chiropractic license by endorsement shall satisfy the  
requirements of the code, the rules promulgated under the code, and all the following  
requirements:  
(a) Provide the required fee and a completed application on a form provided by the  
department.  
(b) Provide proof, as directed by the department, verifying a current and full  
chiropractic license in another state or in a province of Canada.  
(c) If the applicant is licensed as a chiropractor in a province of Canada, provide  
proof, as directed by the department, verifying that the applicant completed the educational  
requirements in Canada or the United States for licensure as a chiropractor in Canada or  
the United States.  
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(d) Provide proof, as directed by the department, verifying passing scores on either  
of the following examinations for a chiropractic license in another state or in a province of  
Canada to obtain licensure as a chiropractor in another state or province of Canada:  
(i) Parts I, II, III, and IV of the national board examination conducted and scored by  
the NBCE, under R 338.12033.  
(ii) Component A – Chiropractic Knowledge, Component B – Clinical Decision  
Making, and Component C – Clinical Skills Demonstration of the Canadian Chiropractic  
Examining Board’s (CCEB) examinations.  
(2) An applicant who provides proof, as directed by the department, verifying a  
current and full chiropractic license in good standing in another state or in a province of  
Canada for not less than the last 5 years before the date of filing the application for a  
chiropractic license by endorsement is presumed to satisfy the requirements of subrule  
(1)(c) and (d) of this rule.  
(3) An applicant who is or has been licensed, registered, or certified in a health  
profession or specialty by another state, the United States military, the federal government,  
or another country shall disclose that fact on the application form. The applicant shall  
satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application. If licensure  
is granted and it is determined that sanctions have been imposed, the disciplinary  
subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL  
333.16174.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
R 338.12036 Relicensure requirements.  
Rule 36. (1) An applicant whose chiropractic license has lapsed may be relicensed  
within 3 years after the expiration date of the license under section 16201(3) of the code,  
MCL 333.16201, if the applicant satisfies the requirements of the code, the rules  
promulgated under the code, and all the following requirements:  
(a) Provides the required fee and a completed application on a form provided by the  
department.  
(b) Establishes good moral character as defined in, and determined under, 1974 PA  
381, MCL 338.41 to 338.47.  
(c) Provides proof, as directed by the department, verifying the completion of, in the  
3-year period immediately preceding the application for relicensure, 45 hours of continuing  
education in programs approved under R 338.12041, that include both the following  
requirements:  
(i) The required continuing education hours listed in R 338.12041(1)(d) to (g).  
(ii) Not more than 20 continuing education hours in distance learning programs.  
(2) An applicant whose chiropractic license has lapsed may be relicensed more than  
3 years after the expiration date of the license under section 16201(4) of the code, MCL  
333.16201, if the applicant satisfies the requirements of the code and the rules promulgated  
under the code, and all the following requirements:  
(a) Provides the required fee and a completed application on a form provided by the  
department.  
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(b) Establishes good moral character as defined in, and determined under, 1974 PA  
381, MCL 338.41 to 338.47.  
(c) Provides fingerprints as required under section 16174(3) of the code, MCL  
333.16174.  
(d) Provides proof, as directed by the department, verifying either of the following:  
(i) The completion of, in the 3-year period immediately preceding the application for  
relicensure, 45 hours of continuing education in programs approved under R 338.12041  
that include all the following requirements:  
(A) Twenty-four live and in-person continuing education hours on chiropractic  
adjusting techniques.  
(B) The required continuing education hours listed in R 338.12041(1)(d) to (g).  
(C) Not more than 20 continuing education hours in distance learning programs.  
(ii) The applicant holds or has held a valid and unrestricted license in another state  
or a province of Canada in the 3-year period immediately preceding the application for  
relicensure.  
(3) An applicant who is or has been licensed, registered, or certified in a health  
profession or specialty by another state, the United States military, the federal government,  
or another country shall disclose that fact on the application form. The applicant shall  
satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application. If licensure  
is granted and it is determined that sanctions have been imposed, the disciplinary  
subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL  
333.16174.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
R 338.12037 License renewal; continuing education.  
Rule 37. (1) An applicant for renewal shall satisfy the requirements of the code and  
the rules promulgated under the code.  
(2) An applicant for renewal shall complete 30 hours of continuing education in the  
2-year period immediately preceding the renewal application that satisfy R 338.12041.  
(3) Submission of an application for renewal constitutes the applicant's certification  
of compliance with the requirements of this rule. The licensee shall maintain  
documentation of satisfying the requirements of this rule for 4 years after the date of  
applying for renewal. Failure to satisfy this rule is a violation of section 16221(h) of the  
code, MCL 333.16221.  
(4) An applicant shall submit a request for a waiver of continuing education  
requirements to the department for the board’s consideration not less than 30 days before  
the last regularly scheduled board meeting before the expiration date of the license.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
PART 4. CONTINUING EDUCATION  
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R 338.12041 Acceptable continuing education.  
Rule 41. (1) The 30 hours of continuing education required under R 338.12037 must  
satisfy all the following requirements:  
(a) No more than 12 credit hours of continuing education may be earned during one  
24-hour period.  
(b) Not less than 10 hours of continuing education must be completed by attending a  
live, in-person program.  
(c) Credit for a continuing education program or activity that is identical to or  
substantially identical to a program or activity for which the licensee has already earned  
credit during the license cycle must not be granted.  
(d) Under section 16431(2) of the code, MCL 333.16431, at least 1 hour of continuing  
education must be in pain and symptom management. Continuing education in pain and  
symptom management includes, but is not limited to, courses in any of the following:  
(i) Chiropractic manipulative treatment.  
(ii) Manual therapies.  
(iii) Therapeutic exercises for pain management.  
(iv) Behavior management.  
(v) Psychology of pain.  
(vi) Pharmacology.  
(vii) Behavior modification.  
(viii) Stress management.  
(ix) Clinical applications.  
(x) Drug interventions as they related to the practice of chiropractic.  
(e) At least 1 hour of continuing education must be in sexual boundaries.  
(f) At least 1 hour of continuing education must be in ethics.  
(g) Not less than 2 hours of continuing education must be in physical measures.  
(2) In addition to those programs approved under R 338.12042, the following are  
considered acceptable continuing education:  
(a) Attendance at or participation in a continuing education program or activity  
related to the practice of chiropractic, or any non-clinical subject relevant to the practice of  
chiropractic education, administration, management, or science, which includes, but is not  
limited to, live in-person programs, interactive or monitored teleconferences, audio-  
conferences, web-based programs, online programs, and review of journal articles or other  
self-study programs approved or offered by the Michigan Association of Chiropractors  
(MAC) or Providers of Approved Continuing Education (PACE) of the Federation of  
Chiropractic Licensing Boards (FCLB) according to the following:  
(i) If audited, the licensee shall provide a copy of a letter or certificate of completion  
showing the licensee’s name, number of continuing education hours earned, the provider’s  
name or the name of the organization that approved the program or other activity, and the  
date the program or activity was completed.  
(ii) The number of continuing education hours for a specific program or activity is  
the number of hours approved by the approving organization for the specific program or  
activity.  
(iii) A maximum of 30 hours of continuing education may be earned for this category  
in each renewal period.  
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(b) Successful completion of a course or courses related to the practice of  
chiropractic, offered by a chiropractic school approved under R 338.12021, according to  
the following:  
(i) If audited, the licensee shall provide a copy of a letter or certificate of completion  
showing the licensee’s name, the number of continuing education hours earned, the  
school’s name, and the date the course or courses was completed.  
(ii) The number of continuing education hours for a specific course or courses is the  
number of hours approved by the school for the specific course or courses.  
(iii) A maximum of 30 hours of continuing education may be earned for courses  
completed in this category in each renewal period.  
(c) Initial presentation by the licensee of a continuing education program related to  
the practice of chiropractic to a state, regional, national, or international organization. To  
receive credit, the presentation must not be a part of the licensee’s regular job description  
and be approved or offered for continuing education credit by the American Chiropractic  
Association (ACA), the International Chiropractors Association (ICA), or an approved  
program under this rule or R 338.12042. Continuing education under this subdivision is  
subject to the following:  
(i) If audited, the licensee shall provide a copy of the presentation notice,  
advertisement, or letter from the approved program under this rule or R 338.12042,  
showing the date of the presentation and the licensee’s name listed as a presenter.  
(ii) Two hours of continuing education credit are granted for each 50 to 60 minutes  
of presentation. No other credit is granted for preparation of a presentation.  
(iii) A maximum of 10 hours of continuing education may be earned in this category  
in each renewal period.  
(3) Completion of implicit bias training under R 338.7004 during the 2 years  
immediately preceding the application for renewal may be used toward satisfaction of the  
requirements of R 338.12037(2) and subrule (1) of this rule.  
(4) Continuing education programs approved before the effective date of this amended  
rule are considered approved.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
R 338.12042 Approval of continuing education programs.  
Rule 42. (1) A continuing education program provider that is not pre-approved under  
R 338.12041(2) shall petition the board for approval of a continuing education program.  
(2) The continuing education program provider shall complete an application  
provided by the department, file the application and supporting documentation with the  
department for review not less than 120 days before the program date, and satisfy the  
requirements of subrule (3) of this rule.  
(3) The application and supporting documentation must include all the following  
information:  
(a) A description of the sponsoring organization.  
(b) Name, title, and address of the program director.  
(c) An outline of the course.  
(d) A resumé for all speakers or presenters, or both.  
(e) A description of the delivery method.  
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(f) The dates and location or locations that the course will be delivered.  
(g) A description of how attendance is monitored, sample documents, and  
identification of the individual monitoring attendance.  
(h) A sample certificate or other document that will be issued after completion and a  
description of how the participant will be notified.  
(i) If appropriate, a request for recognition in a specific topic area required by R  
338.12041(1)(d) to (g).  
(4) Continuing education programs approved before the effective date of this amended  
rule are considered approved.  
History: 2019 AACS; 2022 AACS; 2023 AACS; 2025 MR 11, Eff. May 7, 2025.  
PART 5. STANDARDS OF PRACTICE  
R 338.12051 Performance of invasive procedure; requirements.  
Rule 51. Under sections 16401(2)(d) and 16423 of the code, MCL 333.16401(2)(d)  
and MCL 333.16423, a chiropractor may perform an invasive procedure if both of the  
following requirements are satisfied:  
(a) The invasive procedure is limited to an examination of the ears, nose, and throat.  
(b) The purpose of the examination is to detect and diagnose human conditions and  
disorders of the human musculoskeletal and nervous systems as they relate to subluxations,  
misalignments, and joint dysfunctions, or to assist the chiropractor in offering advice to  
seek treatment from other health professionals in order to restore and maintain health.  
History: 2019 AACS.  
R 338.12052 Tests; performance or ordering; requirements.  
Rule 52. Under section 16423 of the code, MCL 333.16423, the performance,  
ordering, or use of tests must satisfy all the following requirements:  
(a) The performance and ordering of tests must be for the practice of chiropractic as  
defined in section 16401(1)(e) of the code, MCL 333.16401.  
(b) The performance, ordering, or use of tests must be for the purpose of detecting  
and diagnosing human conditions and disorders of the human musculoskeletal and nervous  
systems as they relate to subluxations, misalignments, and joint dysfunctions, or to assist  
the chiropractor in offering advice to seek treatment from other health professionals to  
restore and maintain health. The performance and ordering of tests may be included as,  
but not limited to, a part of a rehabilitative exercise program.  
(c) The performance and ordering of tests must be substantially equivalent to  
nationally recognized standards.  
History: 2019 AACS; 2022 AACS.  
R 338.12053 Analytical instruments; criteria for approval.  
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Rule 53. Under section 16423 of the code, MCL 333.16423, analytical instruments  
must satisfy all the following requirements:  
(a) The instruments must be used for the practice of chiropractic as defined in section  
16401(1)(e) of the code, MCL 333.16401.  
(b) The instruments must be used for the purpose of detecting and diagnosing human  
conditions and disorders of the human musculoskeletal and nervous systems as they relate  
to subluxations, misalignments, and joint dysfunctions, or to assist the chiropractor in  
offering advice to seek treatment from other health professionals to restore and maintain  
health. The use of the instrument may be included as, but not limited to, a part of a  
rehabilitative exercise program.  
(c) The use of the instrument must be substantially equivalent to nationally  
recognized standards.  
History: 2019 AACS; 2022 AACS.  
R 338.12054 Adjustment apparatus; criteria for approval.  
Rule 54. Under section 16423 of the code, MCL 333.16423, an adjustment apparatus  
must satisfy all the following requirements:  
(a) The apparatus must be used for the practice of chiropractic as defined in section  
16401(1)(e) of the code, MCL 333.16401.  
(b) The apparatus must be used for the purpose of correcting or reducing  
subluxations, misalignments, and joint dysfunctions. The use of the apparatus may be  
included as, but is not limited to, a part of a rehabilitative exercise program.  
(c) The use of the apparatus must be substantially equivalent to nationally recognized  
standards.  
History: 2019 AACS; 2022 AACS.  
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;