Medicare maintenance denials
Manipulation denied for lack of AT or documentation of active treatment. We audit treatment plans and documentation.
Home / Specialties / Chiropractic
Chiropractic medical billing services
Chiropractic billing is narrow and heavily audited: Medicare covers only spinal manipulation (98940–98942), requires the AT modifier for active treatment and expects documentation of subluxation and treatment plans. Commercial payers add visit limits and their own rules on therapy codes.
What makes chiropractic billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether chiropractic claims pay the first time.
- Medicare covers manipulation codes only; exams, x-rays and therapies are non-covered and must be billed with the GA modifier and an ABN or to the patient.
- The AT modifier signals active treatment; maintenance care is not covered and must be billed with GA or to the patient.
- Spinal regions treated must be documented to support 98940 (1–2 regions), 98941 (3–4) or 98942 (5).
- Commercial plans cover therapy codes (97110, 97140) in many cases but apply visit limits and sometimes require authorization.
Denials we see most in chiropractic
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Region count disputes
98941 downcoded for undocumented regions. Documented regions billed.
Therapy code denials
Therapies denied by Medicare as non-covered or by commercial plans for limits. Handled per payer with ABNs where needed.
How Core MB bills for chiropractic
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new chiropractic providers runs in the same system, tracked live in your client portal.
- Medicare compliance support: AT modifier, treatment plans, ABNs.
- Region documentation checks before billing.
- Commercial visit-limit and authorization tracking.
Everything in the service
The full revenue cycle as standard for chiropractic practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Chiropractic billing questions
What does Medicare pay chiropractors for?
Spinal manipulation only, when it is active treatment of a documented subluxation. Exams, x-rays and therapies are not covered and need an ABN if billed to the patient.
What is the AT modifier?
It indicates active treatment rather than maintenance care. Without it, Medicare denies the manipulation.
Do commercial plans cover therapies?
Often, with visit limits and sometimes authorization. We track both per plan.
How do we get started with Core MB for chiropractic billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new chiropractic providers can start at the same time.
More in therapy, rehabilitation and musculoskeletal
Find out what your chiropractic billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.