Chiropractic billing, handled with care
Where chiropractic billing gets difficult
The issues we see most often, and the ones that quietly cost practices the most.
Limited Medicare coverage
Medicare covers only spinal manipulation for subluxation, and other services are the patient’s responsibility.
Active versus maintenance care
Coverage depends on whether treatment is improving the patient’s condition, which must be documented at each visit.
Visit caps and authorizations
Many commercial plans limit visits or require approval through a separate benefit manager.
Patient financial notices
Patients need to understand when a service may not be covered, which sometimes requires a written notice before treatment.
How we handle them
Documentation review
We review notes for the elements Medicare and commercial plans expect, and give your providers clear, practical feedback.
Benefit and visit tracking
We verify coverage, visit limits and authorizations, and track remaining visits for each patient.
Notice and modifier setup
We help your team use advance beneficiary notices and related modifiers consistently.
Clear patient estimates
We help your front desk explain coverage and costs so patients can make informed decisions about care.
Coding notes
General guidance only. Code sets update every year and payer policies vary, so we check current rules on every claim.
- Chiropractic manipulative treatment
- 98940 covers one to two spinal regions, 98941 three to four regions and 98942 five regions. 98943 covers extraspinal regions, which Medicare does not cover.
- AT modifier for Medicare
- Medicare requires the AT modifier for active or corrective treatment. Maintenance care is not covered, and an ABN with modifier GA may be appropriate when the patient chooses to continue.
- PART documentation
- Medicare looks for PART elements: Pain, Asymmetry or misalignment, Range of motion abnormality and Tissue or tone changes. Two of the four are required, and one must be asymmetry or range of motion.
Chiropractic billing questions
Get a free chiropractic revenue audit
Send us a recent aging report and a sample of denials. We’ll show you what we’d fix first.