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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Starting at 2.49%
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4.9/5 Rating
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
Chiropractic manipulative treatment, spinal, 1-2 regions
98941
Chiropractic manipulative treatment, spinal, 3-4 regions
98942
Chiropractic manipulative treatment, spinal, 5 regions
98943
Chiropractic manipulative treatment, extraspinal, 1+ regions
97110
Therapeutic exercise, 15 minutes
97140
Manual therapy techniques, 15 minutes
97014
Electrical stimulation, unattended
97035
Ultrasound therapy, 15 minutes
72100
X-ray lumbar spine, two or three views
99213
Established patient office visit, low MDM

2026 Medicare Allowables for Chiropractic CPT Codes by State

Medicare reimbursement for chiropracticprocedures is not a single national number. Each code's allowable is adjusted by your state's Geographic Practice Cost Index (GPCI) and processed under that state's Medicare Administrative Contractor (MAC), so the same chiropractic CPT code pays a different amount in California than it does in Texas or Florida. The table below shows the 10 core chiropracticcodes our coders bill priced at each state's 2026 locality. The non-facility figure is what an office-based practice collects. The facility figure applies when the service is performed in a hospital-based setting.

Commercial carriers in each state typically reimburse above these Medicare benchmarks and state Medicaid below them, but the Medicare allowable is the contracting anchor every payer negotiation starts from. Compare any individual code across all states with our Medicare fee calculator by state.

2026 Medicare non-facility allowable for Chiropractic CPT codes across high-volume states
CodeChiropractic ProcedureCATXFLNYPAILOHGANCMI
98940Chiropractic manipulative treatment, spinal, 1-2 regions$29.19$26.60$27.08$28.87$26.64$26.70$25.74$26.29$25.84$26.16
98941Chiropractic manipulative treatment, spinal, 3-4 regions$41.84$38.28$38.78$41.36$38.33$38.29$37.11$37.82$37.28$37.63
98942Chiropractic manipulative treatment, spinal, 5 regions$54.05$49.64$50.14$53.46$49.70$49.57$48.20$49.05$48.44$48.80
98943Chiropractic manipulative treatment, extraspinal, 1+ regions$28.36$26.24$27.37$28.66$26.38$27.00$25.49$26.13$25.33$26.16
97110Therapeutic exercise, 15 minutes$31.95$28.91$29.42$31.47$28.94$28.95$27.87$28.52$28.02$28.36
97140Manual therapy techniques, 15 minutes$30.47$27.58$28.08$30.03$27.61$27.64$26.59$27.21$26.73$27.06
97014Electrical stimulation, unattended$13.92$12.60$13.03$13.83$12.64$12.80$12.14$12.48$12.15$12.44
97035Ultrasound therapy, 15 minutes$15.75$14.27$14.70$15.62$14.30$14.46$13.75$14.12$13.77$14.07
72100X-ray lumbar spine, two or three views$46.36$39.90$41.16$44.77$39.85$39.94$37.57$39.05$37.98$38.69
99213Established patient office visit, low MDM$104.31$94.46$98.20$103.97$94.79$96.44$90.97$93.60$90.84$93.44

Full Chiropractic fee detail by state

2026 Medicare allowables for chiropractic CPT codes in California, processed under Noridian Healthcare Solutions (Jurisdiction E). See California medical billing.

2026 Medicare allowables for Chiropractic CPT codes in California
CodeDescriptionNon-FacilityFacility
98940Chiropractic manipulative treatment, spinal, 1-2 regions$29.19$19.31
98941Chiropractic manipulative treatment, spinal, 3-4 regions$41.84$29.59
98942Chiropractic manipulative treatment, spinal, 5 regions$54.05$40.21
98943Chiropractic manipulative treatment, extraspinal, 1+ regions$28.36$20.06
97110Therapeutic exercise, 15 minutes$31.95$31.95
97140Manual therapy techniques, 15 minutes$30.47$30.47
97014Electrical stimulation, unattended$13.92$13.92
97035Ultrasound therapy, 15 minutes$15.75$15.75
72100X-ray lumbar spine, two or three views$46.36$46.36
99213Established patient office visit, low MDM$104.31$59.65

Source: 2026 Medicare Physician Fee Schedule, locality-adjusted by state MAC. Figures are for reference and contracting benchmarks, not a guarantee of payment.

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. The 2026 Medicare allowables for chiropractic CPT codes in every state are in the fee table above. Open any state below for its full payer environment, Medicaid rules, and Medicare MAC policies.

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.

Get Expert Chiropractic Billing Support

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