Rules are created through a public process involving open public meetings and hearings. While each rule is in various stages of rule writing, you're welcome to comment at any time.
Rules are also known as regulations, Washington Administrative Code, or WAC.
The Washington Chiropractic Quality Assurance Commission (CQAC) has authority (RCW18.25) to update and change chapter 246-808 WAC.
- Current rules in progress
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Rule Filing Information Subject of possible rule making: Rulemaking is necessary to achieve the statute’s goals and objectives by providing updated requirements that are clear, concise, and necessary to ensure patient safety. Rulemaking establishes enforceable credentialing requirements and safety mechanisms for patients receiving chiropractic services.
Chiropractic Credentialing Requirements. The Chiropractic Quality Assurance Commission is considering revisions to WAC 246-808-010, 246-808-105 through 246-808-140, 246-808-190, 246-808-510, 246-808-535, and 246-808-801 through 246-808-830 to clarify, streamline, and modernize the rule language to be consistent with current laws and practice standards.
The commission is also considering technical amendments to implement Substitute Senate Bill (SSB) 5496 (Chapter 43, Laws of 2022). SSB 5496 updated terminology, definitions, and references for chiropractors. SSB 5496 also made clarifications to confidentiality protections in RCW 18.130.070 for health professional monitoring programs.
- Workshops
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Rules Date and Location Rules Workshop - The Commission is considering revisions to WAC 246-808-010, 246-808-105 through 246-808-140, 246-808-180, 246-808-181, 246-808-190, 246-808-510, 246-808-535 and 246-808-801 through 246-808-830 to clarify, streamline, and modernize the rule language, and to be consistent with current laws and practice standards. The commission will review proposed language and take any necessary action.
July 9, 2026
Department of Health
TC2 Room 164
111 Israel Rd. S.E.
Tumwater, WA 98501This meeting is also available virtually via MS Teams.
Please access the agenda for information on joining the meeting.
- Hearings
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The hearings are open to the public and will be announced here, as well as through GovDelivery. To get announcements subscribe to GovDelivery.
Rules Filing Information Hearing Details - Rules Recently Filed
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CR-103 Permanent Rule Announcement Filing Information Classification of chiropractic procedures and instrumentation
The Chiropractic Quality Assurance Commission (commission) is adopting amendments to WAC 246-808-505, Classification of chiropractic procedures and instrumentation. The commission is adopting the amendments to eliminate ambiguity and clarify which procedures and instruments are permitted for clinical use.
The requirements in the rule have not been updated since 1996. According to RCW 43.70.041, every five years the commission must review existing rules to decrease the numbers of rules, simplify the process for obtaining a license, permit or inspection, and decrease the time required for obtaining licenses, permits, and inspections. The intent for the review is to reduce the regulatory burden on businesses while promoting public health and safety. The commission has reviewed this rule with this goal in mind.
The commission is adopting amendments to:- Clarify which procedures and instruments are permitted for use by a chiropractor;
- Eliminate categories that are ambiguous, by providing the categories of (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.
The adopted language replaces the term “classification” with the term “categorization” of procedures and instruments. The term “categorization” was chosen, because the commission wanted to group the instruments into buckets as either “approved” or “nonapproved” and the term “categorization” better meets the intent of the adopted rule than the previous term “classification.”
The commission also amended WAC 246-808-505 to remove the ”research or investigational” category for several reasons. Firstly, the commission did not want to continue classifying procedures and instruments under a category that could be interpreted in a manner that allows a chiropractor to use a procedure or instrument outside of the chiropractor’s scope of practice, or is using a procedure or instrument that is not “approved” by the commission. Secondly, the definition of “research or investigational” stated that “[n]o billing is allowed” for procedures or instruments used under this classification, but the commission does not have authority to determine what a chiropractor may, or may not, bill for. Under RCW 18.25.005(3) the commission is required to provide rules for the type and use of diagnostic and analytical devices and procedures. The adopted rule language removes “research” or “investigational” as an “approved” procedure or instrument.
Under the adopted amendments there will be two categories of treatment (1) “approved” procedures or instruments and (2) “nonapproved” procedures or instruments. Chiropractors will not be permitted to use procedures or instruments listed as “nonapproved.”
The adopted amendments are necessary in order eliminate ambiguity in the rule language and clarify instruments are either “approved” by the commission or “nonapproved.”
The adopted rule language also enables the commission to better regulate the competency and quality of chiropractors under its jurisdiction. The amended rules establish, monitor, and enforce qualifications for consistent standards of practice while promoting the delivery of quality health care to the residents of the state, which is required under RCW 18.25.0171.
Chiropractic and X-ray Technician Licensure, Registration, Renewal, and Other Fees
The Chiropractic Quality Assurance Commission (commission) works with the Department of Health (department) to protect and improve the health of all people in Washington State. The commission protects the health, safety, and welfare of Washingtonians by ensuring that practitioners credentialed by the commission meet all licensure requirements, administering the disciplinary process promptly, fairly, and efficiently, and providing regular communications with the public and profession. The commission accomplishes this work, in part, through regulation of chiropractors and chiropractic x-ray technicians (chapter 18.25 RCW).
State law, RCW 43.70.250 requires license fees for professions, occupations, and businesses, to fully fund the work of licensing and regulating health care professions. The current fee amounts in WAC 246-808-990 - Chiropractic fees and renewal cycle does not generate sufficient revenue to recover operating expenditures for the commission.
The commission ended fiscal year (FY) 2024 with a fund balance of $95,000 and a revenue shortfall of $403,000. The commission is forecasted to continue operating at a deficit, contributing to further decline of the fund balance through FY2032.
Considering the commission’s financial forecast, the department is adopting a fee increase to bring revenue into alignment with the cost of licensing and regulating chiropractic professions.
- Comment on Rules
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The Chiropractic Quality Assurance Commission values your input and we sincerely encourage you to send us your comments on any rule in progress. You may send your comments to:
Department of Health
Attn: Chiropractic Commission Rules
P.O. Box 47858
Olympia, WA 98504-7858E-mail: cqac@doh.wa.gov
Phone: 360-236-2868You may also submit comments using the online rules comment page.