From CMT code selection to AT modifiers and visit-limit tracking, our certified coders keep your documentation tight and your claims clean, so chiropractors get paid for the care they deliver.
Chiropractic claims are among the most heavily audited in outpatient care. Payers scrutinize medical necessity, spinal region counts, and the line between active treatment and maintenance care. A small documentation gap can turn a routine adjustment into a denial or a recoupment letter. We build your billing process around these rules so your visits stay compliant and fully paid.
Between annual visit caps, prior authorizations, and payer-specific modifier rules, chiropractic claims fail in ways other specialties rarely see. We catch these issues before the claim leaves your office.
We apply the AT modifier for active spinal subluxation treatment, flag maintenance visits, and manage ABNs with GA/GZ modifiers to ensure proper billing of non-covered services.
We audit notes for PART criteria, clear treatment goals, and accurate SOAP documentation, flagging missing findings and copied notes before payer audits.
Many plans cap chiropractic visits per year or route them through networks like American Specialty Health or Optum. We track remaining visits and authorizations, so you never treat into a denial.
From the first consultation to the final re-evaluation, we code and bill the services chiropractic practices perform every day.
Accurate selection between 98940, 98941, and 98942 based on documented spinal regions, plus extraspinal 98943 where payers allow it.
Proper E/M coding for new patient exams and periodic re-exams, billed with modifier 25 when performed alongside CMT.
Correct billing of 97140, 97110, 97012, and 97124, with modifier 59 or XS and separate-region documentation to clear NCCI edits.
Covered-service rules, AT modifiers, and plan-specific limits handled correctly, with no surprises on exam or X-ray denials.
PIP, MedPay, and attorney lien cases tracked from first visit to settlement, with itemized billing and clean records.
State fee schedules, claim numbers, and progress report requirements managed so work-injury claims don’t age out.
We manage the full chiropractic revenue cycle: eligibility and visit-limit checks, charge entry, coding and documentation review, claim scrubbing, payment posting, denial appeals, and patient balance follow-up. Your team stays focused on patient care, not payer portals.
In a high-volume practice, small mistakes repeat daily: a missing AT modifier, an unbilled re-exam, therapy codes bundled into CMT, or timely-filing windows that expire on aging claims. Hiring and training an in-house biller who knows chiropractic payer rules is expensive, and turnover leaves your cash flow exposed. Outsourcing to RCM360 gives you a dedicated team, predictable monthly costs, and reports that show exactly where revenue is leaking.
We work directly inside your existing chiropractic EHR or practice management system, whether it is a specialty platform or a general one. There is no migration, no duplicate data entry, and no change to your clinical workflow.
Request a free, no-obligation billing audit. We’ll review your recent claims, flag modifier errors, undercoded visits, and denial patterns, and show you exactly where revenue is slipping away.
Scope of practice, workers’ comp fee schedules, and PIP rules vary widely by state. Our team knows the regional requirements, so your claims follow the right guidelines wherever you practice.
Medicare covers only manual manipulation of the spine to correct subluxation (CPT 98940–98942). Exams, X-rays, and therapies are not covered. We apply the AT modifier for active treatment and use ABNs to bill non-covered services to patients correctly.
Yes, when documentation supports it. Services like 97140 often bundle with CMT unless they are performed in a separate region. We apply modifier 59 or XS only when the notes justify it, so you avoid denials and audit risk.
We track PIP, MedPay, and attorney lien cases separately, maintain itemized billing and detailed records, and follow up with carriers and attorneys until the case is resolved.
We monitor remaining visits at every appointment and alert your front desk before the limit is reached. You can then request additional authorization or discuss self-pay options with the patient.
Let our certified chiropractic billers handle AT modifiers, visit limits, and payer denials, so your clinic gets paid in full while you focus on getting patients back to moving pain-free. Book your free audit and see what you’ve been missing.
