In-depth articles on chiropractic billing services, Medicare spinal manipulation coverage, AT modifier requirements, active vs. maintenance care tracking, and how to maximize reimbursements for chiropractic practices.
Chiropractic billing operates under a narrower set of covered services compared to most medical specialties, which makes accurate coding and documentation particularly important for practice revenue. Medicare coverage for chiropractic services is limited to manual manipulation of the spine (CMT codes 98940, 98941, 98942) to correct subluxation, and the subluxation must be documented either through X-ray findings or physical examination within specific timeframes. This restrictive coverage framework means that even small documentation gaps can result in denied claims and lost revenue.
The AT modifier plays a central role in chiropractic Medicare billing by indicating that the service rendered is part of an active treatment plan rather than maintenance care. CMS distinguishes between active corrective treatment, which is covered, and maintenance therapy intended to prevent regression, which is not covered under Medicare. Practices must establish clear treatment plans with measurable functional goals and regularly reassess patient progress to justify continued use of the AT modifier. Incorrect application of the AT modifier is a frequent audit trigger and can lead to significant recoupment demands.
Beyond Medicare, chiropractic practices must also manage billing for ancillary services such as therapeutic exercises, electrical muscle stimulation, and spinal decompression therapy across commercial and workers compensation payers. Each payer applies different rules regarding covered services, visit limits, and pre-authorization requirements. Medtransic provides expert chiropractic billing services that help practices navigate these payer-specific complexities, ensure proper AT modifier usage, document the active versus maintenance care distinction clearly, and submit clean claims that maximize reimbursement. Our team helps chiropractors focus on patient care while we handle the intricate billing and compliance demands of this specialty.
Need help with chiropractic billing? Contact Medtransic today. Call 888-777-0860 or visit our contact page.