When you’re dealing with chiropractic care billing, understanding CPT code 98941 isn’t just important, it’s essential. At Cures, we’ve helped countless providers streamline their billing and maximize reimbursement for services like 98941. In this guide, we’ll break down what this code means, how to bill it accurately, and whether Medicare covers CPT code 98941.
Whether you’re a new chiropractor or an experienced provider struggling with denials, this post has the answers. Let’s dive into everything you need to know about CPT code 98941 chiropractic billing.
CPT code 98941 is used to report chiropractic manipulative treatment (CMT) involving three to four spinal regions. This is a common service in chiropractic offices and is typically performed by a Doctor of Chiropractic (DC).
At Cures MB, we often see providers unsure when to choose 98941 vs 98940 (1-2 regions) or 98942 (5 regions). Correct coding is essential for accurate claims and expedited payments.
You should report CPT 98941 when the chiropractor adjusts three or four spinal regions during a session. Make sure to document the regions treated in your SOAP notes—this supports the medical necessity if audited.
If only 1–2 areas are treated, use CPT code 98940. If all five regions are addressed, then CPT code 98942 is appropriate.
Yes but only when it’s medically necessary and tied to active treatment.
Medicare does not cover:
Also, keep in mind that the 98941 GA modifier may be needed if you expect a denial but still want the patient billed. The GA modifier tells Medicare the patient signed an ABN (Advance Beneficiary Notice).
Reimbursement varies based on:
CPT 98941: $33.58 (subject to geographic adjustments)
For commercial plans, rates may range from $40 to $70+. But reimbursement also depends on documentation, correct modifiers, and timely filing, things our experts at Cures MB manage daily for our clients.
Patients paying out-of-pocket can expect to pay between $45–$85 per session, depending on the practice location and visit length.
When billing 98941, always inform patients about costs upfront, especially if the GA modifier is used and they may be responsible for payment.
While CPT 98941 covers spinal manipulation, CPT code 98943 is used for extraspinal manipulations, like:
It’s important not to bill 98943 alongside 98941 for the same body region—this can result in overbilling and audits.
Chiropractors frequently provide adjunct therapies alongside spinal manipulation. While CPT 98941 covers the adjustment, these codes may also be relevant:
Always ensure services are medically necessary and documented to support separate billing.
Depending on the payer, you may need additional modifiers, such as:
Using the right modifier combination can mean the difference between full reimbursement and a denied claim.
At Cures MB, we’ve worked with hundreds of chiropractors. One of our clients in California faced consistent 98941 denials from Medicare. After reviewing the claims, we noticed the AT modifier was missing, and SOAP notes lacked specific spinal regions.
We provided EHR documentation tips, corrected coding errors, and resubmitted the claims. Within 30 days, they received over $8,000 in back payments.
“The Cures MB team understood the coding better than we did—now we just focus on our patients.” —Dr. Stevens, DC
Understanding CPT code 98941 is more than just knowing the definition. It’s about correct usage, modifier application, and proper documentation. At Cures MB Billing Services, we combine deep coding knowledge with hands-on support to help your practice get paid faster, with fewer denials.
Let’s simplify your chiropractic billing, so you can focus on healing.
Need Help with 98941 Claims?
Contact Cures MB Billing Services today and let our experts take over your chiropractic billing.
Visit our Chiropractic Billing Services or call us at +1 (917)-994-9941 for a free consultation.
CPT code 98941 is used to bill for chiropractic manipulative treatment involving three to four spinal regions. It’s commonly used by chiropractors to document and charge for adjustments covering multiple spine areas.
Yes, most often you need to add the modifier AT, which means Active Treatment. This modifier is especially important for Medicare claims to show the treatment is not maintenance care and is medically necessary.
Medicare covers CPT code 98941 only when it’s part of medically necessary active treatment. It generally does not cover maintenance or preventative care, so documentation and use of the modifier AT are critical.
98940 is for chiropractic manipulation of one or two spinal regions, while 98941 covers three to four regions. It’s important to choose the correct code based on how many spinal regions are treated.
Medicare reimbursement for CPT code 98941 averages around $33.58 but varies by region. Commercial insurance may reimburse higher amounts, typically ranging from $40 to $70+ per session.
The GA modifier indicates the patient has signed an Advance Beneficiary Notice (ABN), meaning they understand Medicare may deny payment, and they agree to pay out-of-pocket if that happens.
Yes, adjunct therapies like 97110 (therapeutic exercises) or 97140 (manual therapy) can be billed separately if documented properly. Ensure all billed services are medically necessary and supported by your notes.
Besides modifier AT, you might also need modifiers like 59 (distinct procedural service), GY (non-covered), or GZ (expected denial without ABN), depending on the payer and the situation.
While 98941 covers spinal manipulations, 98943 is for extraspinal manipulations such as shoulder or knee adjustments. These should not be billed together for the same treatment area to avoid overbilling.
Discover Cures Medical Billing Services Across Different States
FL
NY
ML
CO
NJ
AZ
TX
CA
WA
We are a team of national medical billing service experts based in Astoria, NY, committed to providing ongoing value to our customers. We leverage technology and implement best practices to provide high-quality and cost-efficient medical billing solutions from domestic locations, enabling customers to achieve their business goals. Cures Medical Billing is the best option for any medical billing needs.
Medical billing around Astoria, NY, and beyond is our core competency and our specialists will efficiently manage all your billing needs. Our medical billing specialists have over 12 Plus years of experience with all security technologies to ensure data integrity for our customers. Using our medical billing service, anyone can make their medical billing task less resource-consuming.
Discover unparalleled efficiency and precision in healthcare financial management with Cures Medical Billing Solutions.