ClaimCarePro

Chiropractic Billing Services

ClaimCarePro is a chiropractic billing company for 6% of collections ($1,000/month minimum, month-to-month, no setup fee). Our chiropractic billing services cover CMT and therapy coding, AT / GA / GP modifier compliance, Medicare active-treatment documentation, visit-cap tracking, Florida PIP billing and payer credentialing for solo, multi-doctor and integrated practices.

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What our chiropractic billing services include

Illustration of specialists reviewing chiropractic CPT and ICD-10 codes for spinal manipulation and therapeutic procedures

CMT and therapy coding

Chiropractic manipulative treatment coded to the regions documented (98940 for 1–2 spinal regions, 98941 for 3–4, 98942 for 5, 98943 extraspinal), with same-day therapies (97110, 97140, 97012, 97014) and exams (99202–99215 with modifier 25) billed where the payer and the note support them.

Illustration of insurance verification for chiropractic benefits, visit limits and medical necessity requirements

Benefit verification and visit tracking

Chiropractic visit caps, copays, deductibles, authorization rules and whether therapies are covered at all — verified before the first visit and tracked per patient so care never runs past coverage unannounced.

Illustration of chiropractic documentation that supports medical necessity for active treatment

Medicare active-treatment compliance

Medicare pays a chiropractor for CMT only, only with the AT modifier, only with a subluxation diagnosis supported by PART documentation. Maintenance care is billed with GA and an ABN on file, so the patient balance is collectible and the audit risk is not yours.

Illustration of chiropractic claim denial analysis and appeal strategy

Denials, PIP and cash reconciliation

Bundling and medical-necessity denials appealed with the note, Florida PIP claims priced to the §627.736 schedule with the $10,000 benefit tracked, and cash-plan payments kept separate from insured care with compliant fee policies.

Billing service, billing software, or EHR + billing

Billing software gives your staff the tools and leaves them the work. A billing service does the work — coding, submission, denials, posting, follow-up — inside the system you already use. An EHR + billing bundle puts notes, scheduling and claims in one place. We offer the service on its own, or paired with ClaimCarePro EHR, where chiropractic is the first specialty pack.

Chiropractic billing for small practices

In a solo or two-to-three-doctor office, one person usually runs the front desk, posts payments and chases denials. We take the billing half of that job with the same CMT coding, AT and PIP rules and monthly report a multi-site group gets — and the $1,000 minimum only applies in months you collect less than about $16,667.

Why chiropractic claims deny — and how we prevent it

Medicare covers manipulation and nothing else

Exams, x-rays and therapies by a chiropractor are statutorily non-covered by Medicare; CMT is covered only as active treatment (AT modifier) for a documented subluxation. Billing the rest without an ABN leaves money on the table or puts it at recoupment risk.

PART documentation and functional goals

Pain, Asymmetry, Range of motion and Tissue changes — two of the four, with range of motion or asymmetry among them — plus measurable goals and progress. Notes that read the same every visit are what trigger reviews.

Modifiers decide what pays

AT and GA for Medicare, GP for therapies, 25 on a same-day exam, 59 (or the X-modifiers) when 97140 is performed on a different region than the CMT. One missing modifier denies the line; one wrong modifier invites an audit.

Visit caps and plan limits

Commercial plans often cap chiropractic visits per year, exclude therapies, or require authorization after an initial block. Exceeding a cap means the patient owes the balance — if they were told in advance.

Auto-injury and workers' comp payers

PIP, med-pay and workers' compensation carriers each have their own fee schedules, treatment windows and documentation demands. In Florida the 14-day treatment window and the $10,000 / $2,500 PIP caps shape the entire plan of care.

Cash plans next to insurance

Time-of-service discounts, wellness memberships and insurance billing in the same office need separate fee schedules and compliant policies, or the cash discount becomes the insurer's "usual and customary" fee.

AT denial, step 1: read what Medicare is saying

A Medicare 98940–98942 line comes back denied as not medically necessary. Without the AT modifier, Medicare treats the visit as maintenance care, which it does not cover. The same denial follows an AT claim whose note cannot show active, corrective treatment — so check the note before you touch the claim.

AT denial, step 2: fix it with documentation

The record needs a primary subluxation diagnosis (M99.01–M99.05) with the related symptom, PART findings with asymmetry or range of motion among them, a treatment plan with measurable goals, and notes showing progress. With that in place, a missing modifier is corrected through a reopening, or the denial is appealed with the note attached.

AT denial, step 3: know when the denial is right

If the patient has plateaued, the care is maintenance and AT does not belong on the claim. Bill those visits with GA and a signed ABN on file, and the balance becomes the patient's responsibility instead of a write-off or a future recoupment.

How to choose a chiropractic billing company — six questions, and our answers

Is the price published, minimum included?

The industry range is roughly 5–9% of collections, or $1,000–$3,000 a month flat, and many companies quote only after a sales call. Ours is on this page: 6% of collections, $1,000/month minimum, month-to-month, no setup fee. Aged or denied claims are worked on a 10% contingency — no recovery, no fee.

What will it cost at your collections?

Your fee is 6% of collections or $1,000, whichever is higher. Break-even: $1,000 ÷ 0.06 ≈ $16,667 in monthly collections. A $25,000 month costs $1,500 ($25,000 × 0.06); a $50,000 month costs $3,000. Below about $16,667, the $1,000 minimum is what you pay.

Do they code CMT and Medicare correctly?

Ask how they apply AT, GA and the ABN, and what their first-pass rate is on established accounts. Ours: established accounts run a ~95% first-pass clean claim rate, with regions, modifiers and diagnoses checked against each payer before anything leaves.

Do they track visit caps and PIP benefits?

Remaining visits, authorization status and the Florida PIP balance should be visible before the patient is scheduled. Ours are, so nobody is surprised at checkout and no visit is delivered past what a payer will pay.

Will they sign a BAA, and can you leave?

Any company handling your claims and notes should sign a Business Associate Agreement before it sees a record. ClaimCarePro signs a BAA and bills month-to-month with no setup fee. Long terms and exit fees are the red flag to look for.

Do they handle credentialing and the EHR?

Payer enrollment by the same team that bills the visits — a flat $250 per payer application or the $1,750 new-practice bundle — and ClaimCarePro EHR for practices that want notes, scheduling and billing to run as one system.

How we take over your chiropractic billing

  1. 1

    Coding and documentation audit

    We review 90 days of claims and notes for region counts, modifier use, ABN coverage and PART elements, and show you what is still recoverable and what is at risk.

  2. 2

    Recover the aged A/R

    Bundling denials, PIP underpayments and unworked rejections are appealed and re-priced on a 10% contingency while new claims start flowing.

  3. 3

    Verification and limit tracking

    Benefits, visit caps, authorization triggers and PIP balances configured per payer with a remaining-visits view for the front desk.

  4. 4

    Daily coding and submission

    CMT regions, same-day therapies, exams and modifiers checked on every visit; claims out within 24–48 hours of the signed note.

  5. 5

    Posting, follow-up and reporting

    ERAs posted, denials worked within days, patient balances collected, and a monthly report by provider and payer.

Chiropractic billing services: questions buyers ask

How much do chiropractic billing services charge?
Most outsourced chiropractic billing services charge a percentage of collections — the industry range is roughly 5–9% — or a flat $1,000 to $3,000 a month. ClaimCarePro charges 6% of collections with a $1,000 monthly minimum, no setup fee and month-to-month terms. Aged or denied claims are worked on a 10% contingency; credentialing is a flat $250 per payer application.
What would ClaimCarePro cost at my practice's collections?
Your fee is 6% of what we collect or $1,000 a month, whichever is higher. The two meet at about $16,667 in monthly collections ($1,000 ÷ 0.06). A practice collecting $25,000 in a month pays $1,500; at $50,000 it pays $3,000. Below about $16,667, the $1,000 minimum applies. There is no setup fee.
How do you choose a chiropractic billing company?
Ask six things. Is the price published, minimum included? Do they code CMT by region and apply AT, GA and the ABN correctly? Can they bill PIP and workers' comp? Will they sign a BAA? Is the contract month-to-month? Do you get a monthly report by provider and payer? A vague answer to any of them is the warning.
How does chiropractic billing work?
Each visit is coded to the manipulation performed — 98940, 98941 or 98942 by spinal regions treated, 98943 extraspinal — plus any covered same-day exam or therapy, a diagnosis the note supports and the payer's modifiers (AT, GP, 25). Benefits are verified first; the claim goes out electronically, the remittance is posted, and denials are appealed with the note.
Is there a cheat sheet for chiropractic billing?
The working set: CMT 98940–98943; exams 99202–99215 with modifier 25 when billed the same day; therapies 97110, 97140, 97012 and 97014 (G0283 for Medicare); modifiers AT, GA, GP, 25 and 59; subluxation diagnoses M99.01–M99.05 with the secondary condition. Which combinations a given plan pays is what changes — and what we track.
Does Medicare pay for chiropractic care?
Medicare Part B covers chiropractic manipulative treatment of the spine to correct a documented subluxation, billed with the AT modifier as active treatment. It does not cover exams, x-rays, therapies or maintenance care furnished by a chiropractor. Maintenance visits are billed with GA after the patient signs an Advance Beneficiary Notice, which makes the balance the patient's.
Why did Medicare deny my chiropractic manipulation claim?
Usually because the visit was read as maintenance care: the AT modifier was missing, or the note did not support active treatment. Fix the documentation — subluxation diagnosis, PART findings including asymmetry or range of motion, measurable goals and progress — then correct the claim through a reopening or appeal. Maintenance care is billed with GA and a signed ABN.
What documentation supports medical necessity for a chiropractic claim?
PART findings (Pain, Asymmetry, Range of motion, Tissue changes — at least two, including asymmetry or range of motion), a subluxation diagnosis with the related symptom, a treatment plan with measurable functional goals, and visit notes that show progress toward them. Notes that repeat identically from visit to visit are the fastest route to a payer review.
Can you bill therapies and manipulation on the same day?
Often, yes, when the payer covers therapies and the services are distinct. Manual therapy (97140) on the same region as the manipulation bundles into the CMT; on a different region it is billed with modifier 59 or the appropriate X-modifier and documented separately. Therapies carry the GP modifier where the payer requires it.
Do you handle Florida PIP and personal-injury billing for chiropractors?
Yes. Auto-injury visits are billed under Florida's no-fault statute (§627.736) at the statutory fee schedule; the 14-day treatment window and the $10,000 / $2,500 benefit are tracked per patient, and letter-of-protection balances are reconciled against the settlement. Our Florida PIP billing page covers the full PIP → MedPay → health → LOP waterfall.
Does ClaimCarePro sign a BAA?
Yes. ClaimCarePro signs a Business Associate Agreement (BAA). HIPAA requires one whenever a billing company handles a practice's protected health information, so expect it before claims, remittances or notes change hands. Any chiropractic billing company that hesitates to sign a BAA is one to pass on.
How do you switch chiropractic billing companies without losing claims?
Give your current biller notice under their contract, keep read access to their system through the run-out, and pull an A/R aging report. Most practices are live with ClaimCarePro within two to four weeks: an audit in week one, verification set up in week two, new claims from then on while the old A/R is worked in parallel.
Which EHRs and practice-management systems do you work in?
We work in Practice Fusion, EZClaim and NextGen, including HealthFusion. Tell us which EHR or practice-management system your practice uses and we will confirm whether we work in it before you sign anything. Every practice we work with signs a Business Associate Agreement before we touch protected health information.

See what your chiropractic A/R is actually worth

Last updated October 8, 2026. Reviewed by Jacob Greenberg, founder, ClaimCarePro. Send us 90 days of claims and we will show you the bundled lines, the missing modifiers, the PIP underpayments and the denials that can still be appealed.

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