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Chiropractic billing for manipulation, exams and therapies
Billing for chiropractic practices: spinal manipulation by number of regions, the AT modifier for Medicare active treatment, maintenance care and more.
How chiropractic billing works
Chiropractic manipulative treatment is coded by the number of spinal regions treated: 98940 (1–2 regions), 98941 (3–4) and 98942 (5). Medicare covers only manual manipulation of the spine to correct a subluxation, and requires the AT modifier for active, corrective treatment.
Maintenance care is not covered by Medicare, so an ABN is needed before billing the patient.
Codes we bill every day
| Code | What it covers |
|---|---|
| 98940 / 98941 / 98942 | Spinal manipulation, 1–2, 3–4 and 5 regions |
| 98943 | Extraspinal manipulation |
| AT | Active treatment (Medicare) |
| GA / GZ | ABN on file or not |
| 97140 / 97110 | Manual therapy and exercise (commercial plans) |
Code descriptions are summarized. Payer coverage and documentation rules vary by plan and state.
Denials we prevent
- Missing AT modifier on Medicare claims
- Maintenance care billed as active treatment
- Number of regions not documented
- Exams billed with manipulation without modifier 25
- Visit limits reached under the plan
Questions about chiropractic billing
Do you bill personal injury and auto claims?
Yes, where state rules allow, including liens and auto insurance claims.
Related specialties and services
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