Chiropractic Billing Compliance: Key Takeaways from CMS Article A56273

Medicare coverage for chiropractic care is limited.

CMS Article A56273 sets clear Medicare billing standards for chiropractic care, coding, and documentation in 2025.

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Only spinal subluxation correction is covered. Routine visits, massage, and wellness care are not reimbursed.

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Use CPT codes 98940–98942 correctly. Include modifiers like AT or -25 to ensure claim approval.

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Medicare requires full records of exams, diagnoses, treatment plans, and progress to validate medical necessity.

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Only spinal subluxation correction is covered. Routine visits, massage, and wellness care are not reimbursed.

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Read our latest blog to understand key CMS chiropractic billing updates and stay compliant with Medicare.

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Medicare coverage for chiropractic care is limited.

New 2025 rules make billing errors costly for providers.

CMS Article A56273 sets clear Medicare billing standards for chiropractic care, coding, and documentation in 2025.

Only spinal subluxation correction is covered. Routine visits, massage, and wellness care are not reimbursed.

Covered Services Under Medicare

Use CPT codes 98940–98942 correctly. Include modifiers like AT or -25 to ensure claim approval.

Accurate Coding & Modifiers Matter

Medicare requires full records of exams, diagnoses, treatment plans, and progress to validate medical necessity.

Strong Documentation is a Must

Only spinal subluxation correction is covered. Routine visits, massage, and wellness care are not reimbursed.

Regional Rules Apply via MACs

Read our latest blog to understand key CMS chiropractic billing updates and stay compliant with Medicare.