Chiropractic Care Billing Services

Chiropractic billing comes down to three things on every visit: how many spinal regions were adjusted, which payer is paying, and whether the patient is still improving. The same three-region adjustment can be paid in full by a commercial plan, paid only with the right modifier by Medicare, or denied as maintenance care once the patient plateaus. A practice that treats all three the same way will see denials that look random but follow a strict pattern.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for chiropractic practices, built around the region, modifier, and coverage rules that actually decide whether chiropractic claims pay.

Chiropractic care billing challenges

Manipulation codes are chosen by the number of spinal regions treated, not by technique or time. CPT recognizes five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. Treating one or two regions bills as 98940, three or four as 98941, and all five as 98942, while extraspinal manipulation bills as 98943. The note must name each region treated and the findings that justified treating it. Billing for more regions than the note documents is an upcoding finding, and billing for fewer than were treated leaves revenue uncollected.
Medicare coverage is narrow and modifier-driven. Medicare covers only manual manipulation of the spine to correct a subluxation, when it is active, corrective treatment, and the AT modifier is required on those claims to signal active treatment. A claim without AT is treated as maintenance therapy and denied, while appending AT to a visit the record shows as maintenance is the pattern Medicare audits look for. Medicare does not cover the extraspinal code, maintenance therapy, or services like X-rays, exams, and therapy modalities when performed by a chiropractor, so those need the correct non-covered handling rather than a standard claim.
Commercial payers add a third layer. Many manage chiropractic through networks that credential separately, and manual therapy on the same day as manipulation needs a separate body region plus a distinct-service modifier to avoid being denied as bundled. Visit limits, authorization rules, and diagnosis-to-region matching vary by plan, so the same visit can pay under one contract and deny under another.

What MedPlus RCM handles for chiropractic care practices

  • End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
  • Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
  • Provider credentialing and enrollment. End-to-end enrollment with commercial payers and Medicare, plus re-credentialing maintenance.
  • Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
  • A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
  • Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
    We serve chiropractic practices of every size, including family chiropractic, sports chiropractic, pediatric, rehabilitation-focused, and multi-doctor clinics.

Results chiropractic care practices can check

MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.

Frequently asked questions

What decides whether we bill 98940, 98941, or 98942?
The number of spinal regions documented as treated: one or two regions is 98940, three or four is 98941, and five is 98942. The note must name each region.
What is the AT modifier, and when is it required?
AT signals active, corrective treatment and is required on Medicare manipulation claims. Without it, Medicare treats the visit as maintenance care and denies it. It must never be appended to a maintenance visit.
Does Medicare cover chiropractic X-rays or exams?
No. Medicare covers only spinal manipulation to correct a subluxation. Exams, X-rays, and therapy modalities performed by a chiropractor are not covered and need correct non-covered handling.
Can we bill manual therapy on the same day as an adjustment?
Yes, when it addresses a separate body region and is reported with a distinct-service modifier. Otherwise it denies as bundled into the manipulation.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.

Get a free financial audit

Find out where your chiropractic practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
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