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.
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.
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.
| Code | Chiropractic Procedure | CA | TX | FL | NY | PA | IL | OH | GA | NC | MI |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 98940 | Chiropractic 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 |
| 98941 | Chiropractic 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 |
| 98942 | Chiropractic 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 |
| 98943 | Chiropractic 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 |
| 97110 | Therapeutic exercise, 15 minutes | $31.95 | $28.91 | $29.42 | $31.47 | $28.94 | $28.95 | $27.87 | $28.52 | $28.02 | $28.36 |
| 97140 | Manual therapy techniques, 15 minutes | $30.47 | $27.58 | $28.08 | $30.03 | $27.61 | $27.64 | $26.59 | $27.21 | $26.73 | $27.06 |
| 97014 | Electrical stimulation, unattended | $13.92 | $12.60 | $13.03 | $13.83 | $12.64 | $12.80 | $12.14 | $12.48 | $12.15 | $12.44 |
| 97035 | Ultrasound therapy, 15 minutes | $15.75 | $14.27 | $14.70 | $15.62 | $14.30 | $14.46 | $13.75 | $14.12 | $13.77 | $14.07 |
| 72100 | X-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 |
| 99213 | Established 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.
| Code | Description | Non-Facility | Facility |
|---|---|---|---|
| 98940 | Chiropractic manipulative treatment, spinal, 1-2 regions | $29.19 | $19.31 |
| 98941 | Chiropractic manipulative treatment, spinal, 3-4 regions | $41.84 | $29.59 |
| 98942 | Chiropractic manipulative treatment, spinal, 5 regions | $54.05 | $40.21 |
| 98943 | Chiropractic manipulative treatment, extraspinal, 1+ regions | $28.36 | $20.06 |
| 97110 | Therapeutic exercise, 15 minutes | $31.95 | $31.95 |
| 97140 | Manual therapy techniques, 15 minutes | $30.47 | $30.47 |
| 97014 | Electrical stimulation, unattended | $13.92 | $13.92 |
| 97035 | Ultrasound therapy, 15 minutes | $15.75 | $15.75 |
| 72100 | X-ray lumbar spine, two or three views | $46.36 | $46.36 |
| 99213 | Established 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.
Revenue Opportunities Most Chiropractic Practices Miss
Payer-Specific Chiropractic Billing Tips
Chiropractic Billing Best Practices
Practical tips from our coding team to maximize reimbursement and minimize denials.
Get Expert Chiropractic Billing Support
Free billing assessment for your chiropractic practice. See where revenue is leaking.
What We Handle for Chiropractic Practices
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
Get Expert Chiropractic Billing Support
Stop losing revenue to chiropractic coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.