Chiropractic Billing
Navigate spinal manipulation codes, documentation requirements, and Medicare guidelines.
Chiropractic practices face severe insurance limitations, especially with Medicare. We ensure your spinal manipulation codes and modalities are backed by compliant clinical documentation.
Chiropractic billing is widely recognized as one of the most heavily audited specialties in healthcare. Medicare only covers active spinal manipulation for acute/subacute subluxations, demanding perfect clinical records and the strict use of the AT modifier.
Our team knows exactly how to navigate this restrictive environment. We audit your documentation to verify that the PART criteria (Pain, Asymmetry, Range of motion, Tissue changes) are properly detailed in every single SOAP note.
We ensure that commercial chiropractic limits, spinal level definitions, and physical modalities are billed correctly to capture maximum allowable reimbursements without triggering regulatory red flags.
What you get
- Manipulation Code Experts
- Deep familiarity with CMT codes (98940, 98941, 98942) and their corresponding documentation rules.
- Medicare Chiropractic Audits
- We strictly manage the AT modifier (Active Treatment) to defend against pre-payment audits and clawbacks.
- Integrated Physical Modalities
- Accurate billing of therapeutic exercises, traction, and electrical stimulation when billed alongside CMT.
How it works
- 1
SOAP Note Audit
We check daily notes for subluxation diagnosis, PART criteria, and specific treatment levels.
- 2
CMT and Modality Coding
Spinal level counts are cross-referenced with manipulation codes (98940-98942) to ensure billing compliance.
- 3
Medicare AT Verification
The AT modifier is applied only to active, corrective treatments, while routine/maintenance claims are billed appropriately.
- 4
Statement Cycle Posting
We manage patient co-insurance and deductible collections, which are critical for chiropractic clinic revenue.
Common questions
Does Medicare cover chiropractic maintenance therapy?
No, Medicare only covers active corrective treatment. We help you use the ABN (Advance Beneficiary Notice) form to bill patients directly for maintenance.
How do you handle X-ray billing?
If your clinic takes X-rays, we bill them with appropriate professional/technical split modifiers, depending on your machinery ownership.
Do you verify chiropractic session limits?
Yes, commercial insurances often cap visits at 12-20 per year; we verify and track these counts before visits occur.
See what your practice is leaving on the table.
Send us a recent aging report and denial summary. We will show you where the money is stuck and what it would take to collect it.