Subluxation on the record
Medicare limits chiropractic coverage to manual manipulation of the spine to correct a subluxation shown by X-ray or physical exam. The note needs the spinal level and the initial treatment or exacerbation date.
Chiropractic billing is a documentation problem first
Medicare covers chiropractic manipulation of the spine for subluxation only, and CMS traces most improper chiropractic payments to documentation. Taiga drafts codes from notes for your approval and works every denial. Chiropractic is not on its named specialty list, so bring your service mix for a direct answer.
Book a demoThree lines chiropractic claims must hold
Payers check the same few points on almost every chiropractic claim.
Active care versus maintenance
Manipulation codes 98940 through 98942 carry the AT modifier only for active or corrective treatment. Once a condition stabilizes, further manipulation is maintenance therapy, which Medicare does not cover.
Non-covered services and notices
Exams, X-rays, and other services a chiropractor performs fall outside Medicare's chiropractic benefit. Modifiers such as GA and GZ, and any notices given to patients, have to match what actually happened.
Splitting chiropractic billing work
The treatment plan and daily notes come from your doctors. Claims and follow-up can move.
What the practice keeps
Exams, treatment plans with goals and visit frequency, daily notes, and approval of each code and modifier.
What Taiga takes on
Claim scrubbing and submission, eligibility checks, patient statements, and every denial and appeal, low-dollar visits included.
What needs a decision
Agree on who issues advance beneficiary notices, how cash plans stay separate from insurance visits, and who handles personal injury or auto claims.
Bring these to a chiropractic fit call
De-identified notes and a recent denial are the most useful examples. The booking form is not the place for patient details.
How do insurance and cash visits split?
Estimate the share of Medicare, commercial, personal injury, and cash or membership visits.
How are treatment plans written?
Show how your notes record the subluxation level, goals, objective measures, and visit frequency.
Which system holds the notes?
Name the EHR or practice software and who reviews codes and modifiers today.
Who this could fit
Chiropractic practices with meaningful insurance volume and denials piling up. Taiga works alongside your existing system, so the doctors' charting stays the same.
One honest limit
Personal injury, workers' compensation, and auto claims follow state rules this page does not address. Confirm those lines directly with Taiga before counting them in scope.
Questions about chiropractic billing
Does Taiga work with chiropractic practices?
Chiropractic is not on Taiga's published specialty list. Bring your service mix and the team will tell you whether it fits.
When should the AT modifier be used?
For Medicare, only on 98940, 98941, or 98942 when the manipulation is active or corrective treatment. Contractors deny those claims without it, and it should not be added for maintenance care.
Why do chiropractic claims fail on review?
CMS reports that insufficient documentation caused most improper chiropractic payments in its 2024 review. Treatment plans with goals, objective measures, and visit frequency help.
Does Medicare pay for X-rays a chiropractor takes?
Medicare's chiropractic benefit covers manual manipulation of the spine for subluxation only. An X-ray can support the subluxation finding, but the X-ray itself is not part of that benefit.
Bring your chiropractic payer mix
Share your visit types and payers. Taiga will be straight with you about whether the work fits.
System guides show possible billing handoffs, not proven specialty compatibility.