Chiropractic CPT Codes
Chiropractic billing is compact: three spinal manipulation codes graded by regions treated, one extraspinal code, and a set of therapy codes shared with physical therapy. The complexity comes from Medicare, which covers exactly one thing from a chiropractor: spinal manipulation to correct subluxation, and polices it with a modifier that separates active treatment from maintenance.
Reviewed by the ClinicsFlows editorial team · How we source this
Chiropractic CPT codes
Chiropractic Manipulation, 1–2 Spinal Regions
CMT of one or two spinal regions. The most common chiropractic code.
Chiropractic Manipulation, 3–4 Spinal Regions
CMT of three or four regions. Documentation must support each region.
Chiropractic Manipulation, 5 Spinal Regions
CMT of all five spinal regions. Rare, and audited when frequent.
Chiropractic Manipulation, Extraspinal
Manipulation of extremities, head, or ribs. Not covered by Medicare.
Manual Therapy
Soft tissue and joint mobilization. Same-visit CMT requires a separate region and modifier 59.
Traction, Mechanical
Mechanical traction as adjunct therapy. Coverage varies widely by payer.
Codes in blue have full detail pages with documentation requirements, billing mistakes, and FAQ.
Chiropractic billing notes
The CMT codes count spinal regions: 98940 for one or two, 98941 for three or four, 98942 for all five. The documented subluxations have to match the region count, and most visits are honestly 98940 or 98941.
Medicare covers only 98940–98942 from chiropractors, and only with the AT modifier signaling active corrective treatment. Everything else a chiropractor does, exams, X-rays, therapies, is statutorily non-covered by Medicare.
Maintenance care, treatment that maintains rather than improves, is not covered by Medicare even with a subluxation. Patients continuing care past improvement need an ABN so they know they're paying.
Manual therapy (97140) in the same visit as CMT needs to target a separate, non-spinal region with modifier 59, or it bundles into the manipulation.
Documentation follows the PART framework: pain, asymmetry, range of motion, tissue changes. Two of the four, one being asymmetry or range of motion, support the subluxation diagnosis Medicare requires.
Frequently asked questions about chiropractic billing
What does the AT modifier mean on chiropractic claims?▼
Active treatment. Medicare pays chiropractic manipulation only when it's corrective care expected to improve the patient's condition, and AT is the biller's attestation of that. A claim without AT is treated as maintenance and denies. Using AT on actual maintenance care is a false claim, so the treatment plan has to back it up.
Can a chiropractor bill 97140 with a manipulation code?▼
Only when the manual therapy targets a different body region than the manipulation, with modifier 59 and documentation showing the separation. Manual therapy on the same spinal region as the CMT bundles into it, and payers apply that edit automatically.
Does Medicare pay for chiropractic X-rays or exams?▼
No. Medicare's chiropractic benefit covers spinal manipulation (98940–98942) and nothing else: no exams, no X-rays, no therapies from a chiropractor. Patients pay for those directly, and practices should say so upfront rather than surprise-bill after the denial.
Sources
- Code set structure and updates: American Medical Association — CPT
- Fee schedule and component billing rules: CMS Medicare Physician Fee Schedule
- How we research and verify: our editorial policy
CPT® is a registered trademark of the American Medical Association. Content on this page is original educational writing, not a reproduction of AMA-copyrighted descriptions. Verify codes and payer rules before billing.