DEPARTMENT OF HEALTH

(Chiropractic Quality Assurance Commission)

[Filed June 1, 2026, 7:53 a.m.]

Preproposal statement of inquiry was filed as WSR 25-10-041.

Title of Rule and Other Identifying Information: Classification of chiropractic procedures and instrumentation. The chiropractic quality assurance commission (commission) is proposing amendments to WAC 246-808-505 Classification of chiropractic procedures and instrumentation, to eliminate ambiguity and clarify which procedures and instruments are permitted for clinical use.

Hearing Location(s): On July 9, 2026, at 9:30 a.m., at the Department of Health, Town Center 2, Room 164, 111 Israel Road S.E., Tumwater, WA 98501; or virtual via Microsoft Teams at https://teams.microsoft.com/meet/25742753280771?p=xatEYn3djuj77F29Nl, Meeting ID 257 427 532 807 71, Passcode vq3AC3HZ; or dial in by phone +1 564-999-2000,,761719647# United States, Olympia, Phone conference ID 761 719 647#.

Date of Intended Adoption: July 9, 2026.

Submit Written Comments to: Betty Moe, P.O. Box 47858, Olympia, WA 98504-7858, email Betty.Moe@doh.wa.gov, web https://fortress.wa.gov/doh/policyreview, beginning the date and time of filing, by June 25, 2026, 11:59 p.m.

Assistance for Persons with Disabilities: Contact Betty Moe, phone 360-764-6251, TTY 711, email Betty.Moe@doh.wa.gov, by June 25, 2026.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The commission is proposing amendments to WAC 246-808-505 Classification of chiropractic procedures and instrumentation.

The commission is proposing amendments to:

The proposed amendments are necessary to eliminate ambiguous rule language and clarify which procedures and instruments are permitted for use by chiropractors. The proposed rules categorize procedures and instruments as either "approved" by the commission or "nonapproved" and clarify that procedures or instruments categorized as "nonapproved" cannot be used by chiropractors. The commission will update both lists and make them available on the agency website.


•	Clarify language as to which procedures and instruments are permitted for use by a chiropractor;
•	Eliminate ambiguous categories by providing two categories of procedures and instrumentation, (1) "approved" and (2) "nonapproved"; and
•	Permit only procedures and instruments approved by the commission that meet patient safety and evidence-based standards to be used.

Reasons Supporting Proposal: The current rule, WAC 246-808-505 Classification of chiropractic procedures and instrumentation, has not been updated since 1996. The commission, under chapter 18.25 RCW, is required to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing consistent standards of practice and discipline, and those rules, policies, and procedures. The proposed language will eliminate confusion on what instruments and procedures can be used by chiropractors. The commission is proposing rule changes to better promote the delivery of quality health care to the residents of the state.

Statutory Authority for Adoption: RCW 18.25.005 and 18.25.0171.

Statute Being Implemented: RCW 18.25.005.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Chiropractic quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Betty Moe, 111 Israel Road S.E., Tumwater, WA 98501, 360-764-6251.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Betty Moe, P.O. Box 47858, Olympia, WA 98504-7858, phone 360-764-6251, TTY 711, email Betty.Moe@doh.wa.gov.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(3) as the rules only correct typographical errors, make address or name changes, or clarify language of a rule without changing its effect.

Is exempt under RCW 19.85.025(4).

Explanation of exemptions: Although many licensees practice within small businesses, the proposed rules regulate only individual professional standards and do not impose requirements on business operations, staffing, equipment, or reporting. Also, portions of the amended language in WAC 246-808-505 are exempt under RCW 34.05.310 (4)(d) because they clarify language without changing its effect.

Scope of exemption for rule proposal:

Vanessa Wise, DC, Chair

Chiropractic Quality Assurance Commission

AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)

WAC 246-808-505((Classification))Categorization of chiropractic procedures and ((instrumentation))instruments.

(1) ((Procedures, instruments for treatment and/or diagnostic evaluation used by a doctor of chiropractic shall be classified by the commission as follows))The definitions in this subsection apply throughout this section unless the context clearly requires otherwise:

(a) "Approved"((:))means a procedure or instrument ((which))that is ((taught by a))authorized by the commission ((approved chiropractic college for patient))for clinical application ((and not for research or experimental purposes and is allowable by statute. All factors listed under subsection (4) of this section shall be considered before a procedure or instrument is placed in the approved classification))by chiropractors, consistent with the chiropractic scope of practice as defined by RCW 18.25.005.

(b) "Nonapproved ((or experimental": Any))" means a procedure or instrument that does not meet with commission approval and shall not be used by chiropractors. ((A procedure or instrument in this classification shall pass further testing in the laboratory before it can be used on the public. These may be defined by previous declaratory rules or rules and regulations.

(c) "Research or investigational": A procedure or instrumentation that is not approved, but may have a positive benefit in the diagnosis or care of a patient's condition. No billing is allowed for procedures or instruments used under this classification.))

(2) The commission shall categorize chiropractic procedures and instruments as either "approved" or "nonapproved."

(3) The commission shall maintain a ((classified)) list of chiropractic procedures and ((instrumentation. The list shall be made available upon request.

(3) A doctor who intends to use a new procedure or instrument in practice shall notify the commission to determine the classification of the procedure or instrument. If the procedure or instrument is not classified or if new information on a previously classified procedure or instrument is available the doctor shall:

(a) Provide the commission with supporting documentation concerning the use of such a procedure or instrumentation;

(b) Demonstrate sufficient additional training or study for the doctor and utilizing staff to properly use the procedure or instrumentation.

(4) The commission may use the following factors to determine the classification of the procedure or instrumentation, and shall notify the doctor of such classification:))instruments that are "approved" or "nonapproved."

(4) A chiropractor shall not use chiropractic procedures or instruments that are categorized by the commission as "nonapproved."

(5) Any person may submit a request to the commission that a chiropractic procedure or instrument be categorized as "approved" or "nonapproved" by completing and submitting forms supplied by the commission, with any necessary supporting documentation.

(6) When determining whether a chiropractic procedure or instrument be categorized as "approved" or "nonapproved," the commission will review the submitted forms and supporting documentation, and consider, at a minimum, the following factors:

(a) Whether the new procedure or instrument is taught at an approved chiropractic college((.));

(b) Whether there is a scientific basis for the new procedure or instrument((.));

(d) ((Comparison of))The potential ((risk to benefit to the patient.))risks of harm to patients compared to the benefits; and

(e) Any other factors identified by the commission ((may wish to consider)).