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Chiropractic Billing Services

Chiropractic billing has unique rules around spinal manipulation coding, the AT modifier for active treatment, maintenance care exclusions, and Medicare's restrictive coverage policies that differ significantly from commercial payers.

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300+ Practices
98940CMT 1-2 Regions
98941CMT 3-4 Regions
ATActive Tx Mod
97140Manual Therapy

Why Chiropractic Billing Requires Specialty Expertise

Chiropractic billing centers on chiropractic manipulative treatment (CMT) codes 98940-98943 with the critical AT modifier for Medicare active treatment. The distinction between active care and maintenance care determines coverage. Many services covered by commercial payers are excluded by Medicare.

Common Chiropractic CPT Codes

Our coders handle these chiropractic codes daily. This is not an exhaustive list.

Code
Description
98940
CMT 1-2 Regions
98941
CMT 3-4 Regions
AT
Active Tx Mod
97140
Manual Therapy

Chiropractic Billing Challenges We Solve

Common billing problems in chiropractic and how our team handles them.

AT Modifier Requirements

Medicare requires AT modifier on CMT codes to indicate active treatment. Missing it = automatic denial.

Maintenance vs Active Care

Medicare doesn't cover maintenance care. Documentation must establish ongoing medical necessity.

Medicare Limitations

Medicare covers only CMT for subluxation. Exams, X-rays, and therapies require commercial coverage.

Multi-Code Encounters

CMT plus therapy codes require proper documentation separating each service.

Common Chiropractic Denial Reasons

We prevent these before submission and appeal aggressively when they occur.

!
Medicare requires AT modifier on CMT codes to indicate active treatment
!
Medicare doesn't cover maintenance care
!
Medicare covers only CMT for subluxation
!
CMT plus therapy codes require proper documentation separating each service

Revenue Opportunities Most Chiropractic Practices Miss

Chiropractic practices frequently under-bill therapy codes. When a chiropractor provides CMT plus therapeutic exercises, manual therapy, or electrical stimulation, each therapy service is separately billable from the CMT — but only with proper documentation separating each service. For a practice seeing 30 patients per day, adding one therapy code (97110 or 97140) to even 50% of visits at $30-40 per code adds $150,000+ annually. Multi-region CMT coding is the second opportunity. Providers often perform CMT on 3 or 4 regions but document and bill only 1-2 regions (98940). Upgrading to 98941 (3-4 regions) or 98942 (5 regions) where documentation supports it increases per-visit revenue by $20 to $40.

Payer-Specific Chiropractic Billing Tips

Medicare chiropractic coverage is extremely limited — CMT only for documented subluxation with AT modifier. No exams, imaging, or therapies. This makes commercial payer billing essential for chiropractic revenue diversification. Commercial payers cover a broader range of chiropractic services (exams, X-rays, therapies, CMT) but impose visit limits (typically 20-30 visits per year). Some plans carve out chiropractic benefits to specialty networks like American Specialty Health (ASH) that have their own fee schedules and authorization requirements. We track each payer's chiropractic benefit structure and visit limits.

Chiropractic Billing Best Practices

Practical tips from our coding team to maximize reimbursement and minimize denials.

1
Every Medicare CMT claim must include the AT modifier to indicate active treatment. Missing AT = automatic denial with no appeal. This is the single most important chiropractic billing rule.
2
Document subluxation with specific spinal segments (e.g., C5-C6, L4-L5) using palpation findings, X-ray results, or functional assessment. Vague documentation doesn't support the CMT code.
3
Medicare covers ONLY chiropractic manipulative treatment (98940-98943) for subluxation. It does not cover X-rays, exams, therapies, or any other service. Bill those to commercial insurance only.
4
For maintenance care documentation, clearly distinguish between maintenance (not covered by Medicare) and active treatment for an acute or chronic condition with measurable functional goals.

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What We Handle for Chiropractic Practices

CMT coding (98940-98943)
AT modifier management for Medicare
Active vs maintenance care documentation
Therapy code billing (97110, 97140)
Medicare compliance and limitation management
Commercial payer chiropractic billing

Why Choose Go Medical Billing for Chiropractic

Chiropractic billing's unique AT modifier requirements and maintenance care exclusions trip up general billers. Our team handles Medicare chiropractic compliance alongside commercial payer billing.

We serve chiropractic practices in all 50 states, starting at 2.49% of collections. Our credentialing team handles payer enrollment, and our A/R specialists recover aging claims.

Chiropractic Billing by State

We handle chiropractic billing in all 50 states. Select your state for location-specific payer details, Medicaid rules, and Medicare MAC policies.

CaliforniaTexasFloridaNew YorkPennsylvaniaIllinoisOhioGeorgiaNorth CarolinaMichiganNew JerseyVirginiaMassachusettsArizonaTennesseeMarylandIndianaMissouriWisconsinColorado
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Related Resources

Medical Billing & Coding ServicesA/R Recovery ServicesCredentialing & ContractingCase Studies & ResultsPricing

Frequently Asked Questions

We ensure AT is applied to every Medicare CMT claim for active treatment, with documentation supporting ongoing medical necessity.
Yes. Medicare has restrictive coverage (CMT only for subluxation). Commercial payers typically cover a broader range of services. We manage both.

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Stop losing revenue to chiropractic coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.

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