DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR'S OFFICE  
CHIROPRACTIC - GENERAL RULES  
Filed with the secretary of state on February 22, 2022  
These rules take effect immediately upon filing with the secretary of state unless adopted  
under section 33, 44, or 45a(6) of the administrative procedures act of 1969, 1969 PA  
306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become  
effective 7 days after filing with the secretary of state.  
(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)  
R 338.12001, R 338.12021, R 338.12031, R 338.12032, R 338.12033, R 338.12034,  
R 338.12035, R 338.12036, R 338.12037, R 338.12041, R 338.12042, R 338.12052, R  
338.12053, and R 338.12054 of the Michigan Administrative Code are amended as  
follows:  
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.  
June 8, 2021  
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(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.  
PART 2. EDUCATION  
R 338.12021 Educational program standards; adoption by reference.  
Rule 21. (1) The standards of the CCE, as specified in the publication entitled, "CCE  
Accreditation Standards: Principles, Processes & Requirements for Accreditation"  
January 2018, are adopted by reference. The standards are available from The Council  
on Chiropractic Education, 8049 N. 85th Way, Scottsdale, Arizona 85258-4321, or at the  
council's website at http://www.cce-usa.org at no cost. Copies of the standards 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) Any chiropractic educational program accredited by the CCE is considered  
approved.  
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 registration or who is licensed or registered shall complete 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.  
(ii) Identifying victims of human trafficking in health care settings.  
(iii) Identifying the warning signs of human trafficking in health care settings for  
adults and minors.  
(iv) 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.  
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(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  
review journal, health care 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 a sample of individuals and request  
documentation of proof of completion of training. If audited by the department, an  
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 an 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 review journal, health care journal, or professional or  
scientific journal, and date, volume, and issue of publication, as applicable.  
(3) Under section 16148 of the code, MCL 333.16148, the requirements specified in  
subrule (1) of this rule apply for license renewals beginning with the 2016 renewal cycle  
and for initial licenses issued after March 17, 2021.  
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 submit the required fee and a completed  
application on a form provided by the department. In addition to satisfying the  
requirements of the code and the administrative rules promulgated under the code, an  
applicant shall satisfy all the following requirements:  
(a) Submit proof that the applicant has successfully completed 2 years of education in  
a college of arts and sciences and have official transcripts provided to the department  
from the educational institution.  
(b) Submit proof that the applicant has successfully completed at least 1 of the  
following requirements:  
(i) Two years of attendance in a program or institution of chiropractic that satisfies  
the educational standards in R 338.12021 and has official transcripts provided to the  
department from the educational institution.  
(ii) Four semesters of attendance in a program or institution of chiropractic that  
satisfies the educational standards in R 338.12021 and has official transcripts provided to  
the department from the educational institution.  
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(iii) Six quarter terms of attendance in a program or institution of chiropractic that  
satisfies the educational standards in R 338.12021 and has official transcripts provided to  
the department from the educational institution.  
(c) Submit proof that the applicant will be supervised by a licensed chiropractor on a  
form provided by the department.  
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.  
R 338.12034 Licensure by examination; requirements.  
Rule 34. An applicant for a chiropractic license by examination shall submit the  
required fee and a completed application on a form provided by the department. In  
addition to satisfying the requirements of the code and the administrative rules  
promulgated under the code, an applicant shall satisfy both of the following  
requirements:  
(a) Have graduated from a program or institution of chiropractic that satisfies the  
educational standards in R 338.12021 and have final and official transcripts provided to  
the department from the educational institution.  
(b) Have passed parts I, II, III, and IV of the national board examination conducted  
and scored by the NBCE, under R 338.12033. The applicant shall ensure that the NBCE  
issues proof of official passing scores directly to the department.  
R 338.12035 Licensure by endorsement; requirements.  
Rule 35. (1) An applicant for a chiropractic license by endorsement shall submit the  
required fee and a completed application on a form provided by the department. In  
addition to satisfying the requirements of the code and the administrative rules  
promulgated under the code, an applicant shall satisfy either of the following  
requirements:  
(a) Have been licensed in another state of the United States for 5 years or more  
immediately preceding the date of application.  
(b) Have been licensed in another state of the United States for less than 5 years  
immediately preceding the date of filing an application and have passed parts I, II, III,  
and IV of the national board examination that is conducted and scored by the NBCE,  
under R 338.12033. The applicant shall have the NBCE issue proof of official passing  
scores directly to the department.  
(2) An applicant shall have his or her license verified by the licensing agency of any  
state of the United States in which the applicant holds or has ever held a license to  
practice chiropractic. Verification includes, but is not limited to, showing proof of any  
disciplinary action taken or pending against the applicant.  
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R 338.12036 Relicensure requirements.  
Rule 36. (1) An applicant for relicensure whose license has been lapsed for less than 3  
years preceding the date of application may be relicensed under section 16201(3) of the  
code, MCL 333.16201, if the applicant satisfies all the following requirements:  
(a) Establishes that he or she is of good moral character.  
(b) Submits the required fee and a completed application on a form provided by the  
department.  
(c) Submits proof to the department of 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:  
(i) The required continuing education hours listed in R 338.12041(1)(d) to (h).  
(ii) Not more than 15 continuing education hours in distance learning programs.  
(d) An applicant shall have his or her license verified by the licensing agency of any  
state of the United States in which the applicant holds or has ever held a license to  
practice chiropractic. Verification includes, but is not limited to, showing proof of any  
disciplinary action taken or pending against the applicant.  
(2) An applicant for relicensure whose license has been lapsed for 3 years or more may  
be relicensed under section 16201(4) of the code, MCL 333.16201, if the applicant  
satisfies all the following requirements:  
(a) Establishes that he or she is of good moral character.  
(b) Submit fingerprints as set forth in section 16174(3) of the code, MCL 333.16174.  
(c) Submits the required fee and a completed application on a form provided by the  
department.  
(d) Provides either of the following:  
(i) Submits proof to the department of 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 (h).  
(C) Not more than 15 continuing education hours in distance learning programs.  
(ii) Documentation to the department that the applicant holds or has held a valid and  
unrestricted license in another state within 3 years immediately preceding the application  
for relicensure.  
(e) An applicant shall have his or her license verified by the licensing agency of any  
state of the United States in which the applicant holds or has ever held a license to  
practice chiropractic. Verification includes, but is not limited to, showing proof of any  
disciplinary action taken or pending against the applicant.  
R 338.12037 License renewal; continuing education.  
Rule 37. (1) An applicant for license renewal shall complete 30 hours of continuing  
education in the 2-year period immediately preceding the application that satisfy R  
338.12041.  
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(2) This rule does not apply to a licensee who has obtained his or her initial chiropractic  
license within the 2-year period immediately preceding the expiration date of the initial  
license.  
(3) Submission of an application for renewal constitutes the applicant's certification of  
compliance with this rule. The licensee shall retain documentation of satisfying this rule  
for a period of 4 years from the date of applying for license renewal. Failure to satisfy  
this rule is a violation of section 16221(h) of the code, MCL 333.16221.  
PART 4. CONTINUING EDUCATION  
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 1 24-  
hour period.  
(b) At least 15 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 shall 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) At least 2 hours of continuing education must be in physical measures and must be  
completed by attending a live, in-person program.  
(h) At least 2 hours of continuing education must be in performing and ordering tests  
and must be completed by attending a live, in-person program.  
(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  
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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) according to the following:  
(i) If audited, the licensee shall submit a copy of a letter or certificate of completion  
showing the licensee’s name, number of continuing education hours earned, the sponsor’s  
name or the name of the organization that approved the program or other activity, and the  
date on which 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.  
(b) Successful completion of a course or courses related to the practice of chiropractic  
which are offered by a chiropractic school approved under R 338.12021, according to the  
following:  
(i) If audited, the licensee shall submit a copy of a letter or certificate of completion  
showing the licensee’s name, number of continuing education hours earned, the school’s  
name, and the date on which 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 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 must 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 submit a copy of the presentation notice or  
advertisement 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) This rule takes effect beginning with the first renewal cycle after January 7, 2019.  
Continuing education programs approved before the effective date of this amended rule  
are considered approved.  
R 338.12042 Approval of continuing education programs.  
Rule 42. (1) An organization may petition the board for approval of a continuing  
education program.  
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(2) The petition shall be filed at least 60 days before the commencement of the  
program.  
(3) The petition shall include all of 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.  
(f) The dates and location or locations that the course will be delivered.  
(g) A description of how attendance will be monitored, sample documents, and  
identification of the person monitoring attendance.  
(h) A sample certificate or other document that will be issued upon 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 (h).  
PART 5. STANDARDS OF PRACTICE  
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.  
R 338.12053 Analytical instruments; criteria for approval.  
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.  
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(c) The use of the instrument must be substantially equivalent to nationally recognized  
standards.  
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.  
;