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Chiropractic billing

Chiropractic Billing & RCM Services

Chiropractic claims live and die by spinal-region counts, active-treatment rules and visit limits. Specialist billers keep your adjustments, therapies and PI cases paid.

  • CMT codes matched to documented spinal regions
  • Medicare AT modifier, ABN and maintenance-care rules handled
  • Personal injury, auto and workers’ comp claims tracked to settlement

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96%
Clean-claim rate target
30%
Fewer denials with documentation checks
< 30
Days in A/R goal
Overview

Why chiropractic billing is uniquely tricky

Chiropractic manipulative treatment (CMT) is billed by the number of spinal regions treated, and the documentation must support each region with a diagnosis, findings and a treatment plan. Payers also cap the number of visits per year and expect measurable functional improvement to keep paying.

Medicare covers only active corrective treatment of subluxation, requires the AT modifier and specific documentation, and does not pay for maintenance care, which means patients need an Advance Beneficiary Notice (ABN) before non-covered services. Therapies such as exercise, manual therapy and electrical stimulation follow timed-code rules and NCCI edits with CMT.

Many chiropractic practices also treat personal injury and auto accident patients, where claims go to auto insurers, attorneys or workers’ compensation carriers and can take months to settle. A chiropractic billing partner tracks these cases separately so balances are not lost.

Why it's hard

Common chiropractic billing challenges

01

Spinal region documentation

CMT levels (98940–98942) must match the number of regions treated and documented with findings.

02

Medicare active-treatment rules

Without the AT modifier and proper notes, Medicare treats visits as maintenance care and denies them.

03

Visit limits and plan of care

Commercial payers cap visits and require progress updates to approve additional treatment.

04

Therapy bundling with CMT

Billing therapies on the same day as CMT needs proper modifiers and separate documentation.

05

Personal injury and auto cases

Liens, attorney letters and auto carriers require tracking far beyond normal claim cycles.

06

ABN and patient responsibility

Missing ABNs mean the practice cannot bill patients for non-covered maintenance visits.

What's included

What a chiropractic billing partner should handle

  • Benefits checks with visit limits and copays
  • CMT coding by documented spinal regions
  • Medicare AT, GA/GZ modifier and ABN management
  • Therapy coding with timed-unit calculations
  • Plan-of-care and re-exam tracking
  • Personal injury, auto and workers’ comp billing
  • Attorney lien and settlement follow-up
  • Denial management and appeals
  • Patient statements and cash-plan support
  • Credentialing with commercial and Medicare plans
Coding focus

Key codes in chiropractic billing

Code(s)What it covers
98940Chiropractic manipulative treatment, spinal, one to two regions.
98941CMT, spinal, three to four regions.
98942CMT, spinal, five regions.
98943CMT, extraspinal, one or more regions (not covered by Medicare).
97140Manual therapy techniques, each 15 minutes (requires separate region/documentation with CMT).
97110 / 97112Therapeutic exercise and neuromuscular re-education, each 15 minutes.
AT / GA / GZMedicare active treatment modifier and ABN-related liability modifiers.

Code examples are for orientation only. Always code from the current CPT®, HCPCS and ICD-10-CM code sets and payer policies.

Medicare documentation for subluxation

For Medicare, notes must show the subluxation (by x-ray or the PART exam), the treatment plan with goals, and measurable progress. Your billing partner should flag visits that lack these elements before claims are sent.

How it works

Find the right billing partner in four steps

1

Share your goals

Tell us your specialty, monthly claim volume, EHR and the problems you want fixed, denials, slow A/R or staffing gaps.

2

Get a free audit

We review a sample of your claims and aging report to show where revenue is leaking and what a specialist could recover.

3

Compare vetted companies

Shortlist billers with proven chiropractic experience, transparent pricing and verified client reviews.

4

Onboard with confidence

Sign a BAA, connect your EHR and clearinghouse, and track clean-claim rate, days in A/R and collections from month one.

Compare

Top-rated medical billing companies

Billing companies listed on BillerFirms, ranked by client reviews. Ask each one about their chiropractic experience.

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5.0 5 reviews

Who We Are We are Prime Medical Billing Solutions, LLC, a results-driven medical billing and revenue cycle partner headquartered in Atlanta, Georgia. Since about 2015, we have operated with the belief that true value lies in partnering, rather than merely contracting, with providers to ensure personalized attention and peak revenue performance. Founded by seasoned billing professionals with 20+ years of combined expert experience, our home office in Atlanta supports both individual practices and larger provider groups. Our team is passionate about maximizing reimbursements and simplifying the billing journey step by step. What Services We Offer We provide a comprehensive suite of services designed to optimize every phase of the revenue cycle: Claims processing & billing management, including electronic, UB‑04, and HCFA‑1500 formats Accounts receivable and collections, focusing on paid-to...

Atlanta, Georgia
Founded 2015
Claims ProcessingDenial ManagementCredentialing (Payer & License)
No reviews yet

GreenSense Billing is a trusted leader in medical billing and revenue cycle management, providing comprehensive solutions tailored to the unique needs of healthcare providers across the United States. Our mission is to streamline administrative complexities, optimize reimbursements, and enhance financial performance, allowing medical professionals to focus on delivering exceptional patient care. Our Services • We offer end-to-end medical billing and revenue management solutions, including: •  Medical Billing & Coding - Accurate claims processing to maximize reimbursements and minimize denials. •  Revenue Cycle Management (RCM) - A holistic approach to managing claims, payments, and collections. •  Provider Credentialing - Seamless enrollment with insurance networks to ensure timely reimbursements. •  Financial Solutions - Data-driven insights and financial reporting to optimize practice...

Las Vegas, Nevada
Founded 2003
Claims ProcessingDenial ManagementRevenue Cycle Management
No reviews yet

Let’s face it, medical billing shouldn’t be the most challenging part of running a practice. At Medical Lean Management, we take the chaos out of revenue cycle management so you can get back to what matters: delivering excellent patient care. Based in Corona, California, we’re not just another faceless billing company, we’re your partners in efficiency, here to simplify the financial side of healthcare. Why Us? Because We Get It. Paperwork piles up. Claims get denied. Regulations keep changing. It’s enough to make anyone’s head spin. That’s where we step in. We don’t just process claims, we optimize your entire revenue cycle, cutting through the red tape to get you paid faster and with fewer headaches. Our goal? To make your billing so smooth, you’ll wonder how you ever managed without us. Here’s How We Help: ✔ Fewer Denials, More Revenue - Our precision-driven approach slashes claim den...

Corona, California
Founded 1994
Claims ProcessingDenial ManagementRevenue Cycle Management
No reviews yet

Overview & Mission Access Revenue Hawaii, founded in 2022 in Holualoa, Hawai‘i, is a specialized medical billing and revenue cycle management (RCM) company with a primary focus on behavioral and mental health providers. Drawing deeply from social work roots, the leadership team recognized the administrative friction mental health professionals face, credentialing delays, complex payer regulations, EMR documentation requirements, and chose to build a firm that helps clinicians focus fully on patient care. Their mission centers on removing financial and operational barriers so therapists, counselors, and behavioral health groups can thrive financially while delivering quality care to Hawai‘i’s communities. Origin Story & Local Presence The company was born out of a clear insight: behavioral health providers in Hawai‘i suffer unique administrative challenges. From intricate Medicaid billing...

Chandler, Arizona
Founded 2007
Claims ProcessingDenial ManagementRevenue Cycle Management
Pricing

How much does chiropractic billing cost?

Most billing companies charge a percentage of what they actually collect, so their incentive matches yours. Complex specialties sit at the higher end of the range because of prior authorizations, modifiers and appeal work.

Percentage of collections
5% - 9%

Most common. You pay only on money collected.

Per claim
$4 - $10

Predictable for high-volume, low-complexity claims.

Hourly / FTE
$12 - $35/hr

Dedicated billers working inside your systems.

Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.

FAQ

Chiropractic billing FAQs

Spinal adjustments are billed with CMT codes 98940, 98941 or 98942 depending on how many spinal regions were treated and documented.

Medicare requires the AT modifier on CMT claims for active, corrective treatment. Without it, the service is considered maintenance care and is not covered.

Yes, when they are medically necessary and separately documented. Manual therapy on the same region as CMT is usually bundled unless performed on a different region.

Yes. Specialist billers manage auto, PI and workers’ compensation claims, attorney liens and settlement follow-up.

Typical reasons include exceeded visit limits, missing AT modifier, documentation not supporting the regions billed, and lack of progress notes.

Most companies charge about 5% to 9% of collections, with PI case management sometimes priced separately.

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