Chiropractic Billing Services
Chiropractic claims depend on subluxation documentation, AT and GA modifiers, ABNs and visit limits. We handle all of it, plus personal injury and workers’ comp, so your clinic is paid for the care you deliver.
Coverage Rules Make Chiropractic Billing Different
Few specialties face as many coverage limits as chiropractic. Medicare pays only for spinal manipulation for active treatment of a subluxation. Commercial plans cap visits and require medical necessity notes. Personal injury cases bring a separate set of payers, forms and timelines.
AccMed RCM checks documentation, modifiers and patient responsibility before each claim, collects from the right party and keeps your A/R clean across insurance, Medicare and PI cases.
What we handle
- CMT codes 98940–98942 with the correct number of spinal regions
- AT, GA, GY and GZ modifiers and ABN tracking
- Visit limits and medical-necessity documentation checks
- E/M with modifier 25 when separately identifiable
- Therapy and modality codes billed with correct units
- Personal injury, auto (PIP) and workers’ comp claims
Common Chiropractic Codes and Modifiers
| Code / modifier | Meaning | Billing watch-out |
|---|---|---|
| 98940 | CMT, spinal, 1–2 regions | Diagnosis must support each region treated |
| 98941 | CMT, spinal, 3–4 regions | Most audited CMT code — region documentation is key |
| 98942 | CMT, spinal, 5 regions | Needs diagnoses for all five regions |
| 98943 | CMT, extraspinal | Not covered by Medicare for chiropractors |
| AT | Active / corrective treatment | Required on Medicare CMT claims for active care |
| GA | ABN on file | Use for maintenance care you expect Medicare to deny |
Related Services
Chiropractic Billing: Common Questions
What does Medicare cover for chiropractors?
Medicare Part B covers chiropractic manipulative treatment (CMT) of the spine to correct a subluxation — codes 98940, 98941 and 98942 — when it is active treatment. Exams, X-rays, therapies and extraspinal manipulation (98943) are not covered when performed by a chiropractor and are the patient’s responsibility.
When do I use the AT modifier?
The AT modifier tells Medicare that spinal manipulation is active or corrective treatment. Maintenance care is not covered, so it should not carry AT. Claims for active treatment without AT are denied.
What about maintenance care?
Maintenance care is not covered by Medicare. If you plan to provide it, give the patient an Advance Beneficiary Notice (ABN) beforehand and bill with the GA modifier so you can collect from the patient.
Can I bill an E/M visit with an adjustment?
Yes, when there is a separately identifiable evaluation, such as a new patient exam or a new problem, it can be billed with modifier 25. Routine pre-manipulation assessments are part of the CMT code.
Do you bill personal injury and auto claims?
Yes. We handle auto (PIP/med-pay), workers’ compensation and attorney lien claims alongside commercial insurance and Medicare.
Collect What Your Adjustments Are Worth
Our free audit reviews your recent chiropractic claims for modifier, region and coverage errors.