Comprehensive CPT Codes Guide for Chiropractic Care

Chiropractic care plays a crucial role in helping patients manage pain, improve mobility, and enhance their overall wellness. Whether addressing back pain, neck tension, or joint discomfort, chiropractors offer non-invasive, drug-free solutions. However, for chiropractic providers to receive proper reimbursement and maintain billing compliance, accurately using CPT codes for chiropractic treatments is essential.

In this article, we’ll break down what CPT codes are, the most commonly used chiropractic codes, documentation tips, and how correct coding helps streamline insurance claims and boost practice revenue.

What Are CPT Codes?

CPT (Current Procedural Terminology) codes are a standardized set of medical codes created by the American Medical Association (AMA). These codes are used by healthcare providers, insurers, and billing departments to report medical, surgical, and diagnostic procedures.

Every patient service — from a spinal adjustment to a physical therapy modality — must be assigned a CPT code to ensure clear communication and proper reimbursement from insurance companies.

Why Are CPT Codes Important in Chiropractic?

For chiropractors, CPT codes:

• Ensure accurate billing
• Facilitate reimbursement from insurance companies
• Support proper documentation
• Reduce the risk of audits or denied claims

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Chiropractic treatment typically includes spinal manipulations, therapeutic exercises, physical modalities, and patient evaluations. Using the correct codes for each service ensures that the provider gets paid fairly and the patient’s insurance is processed smoothly.

Most Common CPT Codes for Chiropractic Treatments

Below is a list of the most frequently used CPT codes for chiropractic treatments, along with descriptions and documentation tips.

1. Spinal Manipulation Codes (98940 – 98942)

These are the core codes used in chiropractic care:

• 98940 – Chiropractic manipulative treatment (CMT), spinal, 1–2 regions
• 98941 – CMT, spinal, 3–4 regions
• 98942 – CMT, spinal, five regions

These codes are billed once per encounter, and you select the appropriate code based on the number of spinal regions treated. Spinal regions include:

1. Cervical (neck)
2. Thoracic (mid-back)
3. Lumbar (lower back)
4. Sacral (sacrum)
5. Pelvic (pelvis)

Tip: Documentation must include the specific regions adjusted and the clinical rationale for the adjustment (e.g., subluxation or joint dysfunction).

2. Extraspinal Manipulation (98943)

• 98943 – CMT, extraspinal, one or more regions (e.g., extremities such as shoulder, elbow, wrist, knee, ankle, ribs, TMJ)

This code applies when a chiropractor adjusts joints that are not in the spine. It can be billed in addition to spinal manipulation, provided it’s medically necessary and well-documented.

3. Evaluation and Management (E/M) Codes

Initial visits or follow-up exams often involve evaluation and management.

• 99202–99205 – New patient evaluation and management services, depending on case complexity.
• 99212 – 99215 – Established patient E/M services

Use these codes when taking a history, performing an exam, and making treatment decisions. These are not typically billed on every visit, but are appropriate for:

• New patients
• New conditions or injuries
• Re-assessments following significant changes

Important: Many insurance payers do not reimburse for an E/M visit on the same day as a CM, T, unless it is a separate and distinct service (which often requires modifier -25).

4. Physical Therapy Modalities

Chiropractors often use therapeutic modalities as part of a comprehensive treatment plan. Standard CPT codes include:

• 97010 – Hot/cold packs (typically non-billable, considered bundled)
• 97012 – Mechanical traction therapy
• 97014 / G0283 – Electrical stimulation (unattended)
• 97035 – Ultrasound therapy
• 97124 – Massage therapy
• 97140 – Manual therapy (e.g., myofascial release, joint mobilization)
• 97110 – Therapeutic exercises (for strength, endurance, flexibility)
• 97530 – Therapeutic activities (functional activities like lifting, bending)
• 97112 – Neuromuscular re-education

Documentation Tip: Always include duration (in minutes), body region treated, patient response, and clinical necessity.

5. Radiology & Diagnostic Services

Many chiropractors perform in-office imaging, especially X-rays.

• 72020 – X-ray, spine, single view
• 72040 – Cervical spine, 2–3 views
• 72070 – Thoracic spine, two views
• 72100 – Lumbar spine, 2–3 views

Be sure to check state guidelines and payer rules regarding in-office X-ray use and billing.

Using CPT Codes Effectively

Understanding and using these CPT codes correctly is not just about ensuring payment but also about maintaining compliance with healthcare regulations. Chiropractors and their billing staff need to stay informed about CPT code updates and revisions to avoid billing errors and denials. Regular training and reference materials, such as this guide, can help maintain a smooth operational flow within chiropractic practices.

Whether you are a practitioner or a patient in the chiropractic field, knowing these CPT codes can help demystify the billing process and ensure that all parties are on the same page regarding treatment plans and payments.

Documentation Tips for Proper Coding

Correct use of CPT codes is only part of the equation. Accurate and detailed documentation is the foundation of a successful claim.

Here’s what every chiropractic SOAP note should include:

• Subjective findings: Patient complaints, pain levels, symptoms
• Objective findings: Observations, palpation, range of motion, orthopedic tests
• Assessment: Diagnosis, functional limitations, clinical impression
• Plan: Treatment performed, future care plan, home exercises, referrals

Also include:

• Date of service
• Start and end times for time-based codes
• Signature and credentials of the provider

Best Practice: Conduct periodic internal audits to catch documentation or coding inconsistencies before payers do.

How Correct CPT Coding Impacts Your Practice

Mastering CPT codes for chiropractic treatments is more than just a billing task — it’s a crucial part of managing your practice’s financial health and patient trust. Accurate coding:

• Increases revenue through clean claims
• Reduces denials and rework
• Ensures compliance with insurance and Medicare rules
• Supports proper patient care documentation
• Protects your license during audits

Investing in training, hiring certified billers, or partnering with a billing service can elevate your practice’s efficiency and profitability.

Final Thoughts

Understanding and applying the correct CPT codes for chiropractic treatments is essential for chiropractors who want to run a successful, compliant, and profitable practice. From spinal adjustments and extraspinal manipulations to E/M services and physical therapy modalities, every service you provide must be coded accurately and supported by detailed documentation.

With continuous updates from the AMA and evolving insurance regulations, staying educated and proactive is the key to billing success. Make sure your team is trained, your records are audit-ready, and your billing process is clean — because when your coding is correct, everything else flows more smoothly.