In the US, Medicare covers chiropractic services for spinal manipulation using CPT codes 98940 (one-two regions), 98941 (three-four regions), and 98942 (five regions), limited to treatment for subluxation. In Australia, the Medicare Benefits Schedule (MBS) code for chiropractic services under a chronic disease management plan is 10964.
Doctors of chiropractic are limited to billing three Current Procedural Terminology (CPT) codes under Medicare: 98940 (chiropractic manipulative treatment; spinal, one to two regions), 98941 (three to four regions), and 98942 (five regions).
Yes, Medicare (in Australia) covers chiropractic care, but only for patients with chronic conditions through a GP Management Plan, allowing for up to five rebated visits per calendar year, requiring a GP referral and a multidisciplinary care plan. Coverage isn't automatic and has limitations, often leaving a gap payment, as Medicare rebates don't cover the full cost, but it helps reduce out-of-pocket expenses for eligible individuals with ongoing issues like back pain, sciatica, or headaches.
Definition and Use of 97014 CPT Code
The 97014 CPT code is commonly used in chiropractic and physical therapy practices for unattended EMS (Electrical Muscle Stimulation) treatment.
Chiropractic manipulation treatment (CMT)
98940: CMT, one to two areas of the spine. 98941: CMT involves manipulating three to four areas of the spine. 98942: Five areas, spinal manipulation, and CMT.
Chiropractic CPT code 97012 is used for mechanical traction. It is a highly successful treatment method for dislocations, herniated discs, and general but persistent pain in the neck, arms, back, and legs.
As a chiropractor, ensuring that your billing and documentation for therapeutic services are accurate is vital for both compliance and reimbursement. Two key CPT codes that are commonly used in chiropractic practices—97124 for massage therapy and 97140 for manual therapy—require careful attention to detail.
The 97014 CPT code is no longer a Medicare-recognized code and has been replaced by the code G0283. Many but not necessarily all non-medicare insurance providers have adopted this rule as well so it is important to review the coding policies of each plan.
Chiropractic manual therapy involves the use of hands-on techniques to treat soft tissue and mobility restrictions in the extremities, neck and trunk. CPT code 97140 covers manual therapy techniques such as soft tissue and joint mobilization, manipulation, manual lymphatic drainage, and manual traction.
G0283 vs 97014 for physical therapy - which should I use? Use G0283 for Medicare patients and most Medicare Advantage plans. Use 97014 for private insurance unless they specifically require G0283. When in doubt, contact the payer directly.
How many chiropractic visits does Medicare cover in a year? There is no limit on the number of chiropractic adjustments that Medicare will cover, but each appointment must be medically necessary to treat an altered vertebrae position.
Medicare covers multiple manual therapy techniques with proper documentation. Manual therapy is reported using CPT code 97140. CPT code 97140 – Manual Therapy Techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), 1 or more regions, every 15 minutes.
Therapists should distinguish 97124 (massage therapy) from 97140 (manual therapy) based on the treatment goal and follow CMS/AMA guidelines to avoid claim denials.
CPT code 70450 is used to describe a computed tomography (CT) scan of the head or brain performed without the use of contrast dye.
If you treat patients with glaucoma, diabetic retinopathy, or macular degeneration, using 92014 correctly can result in payment of up to $157 per visit, depending on your MAC region.
The 97014 chiropractic CPT code is used for an unattended EMS treatment, which is performed in the office but does not require the presence of the chiropractic provider. Unattended electrical stimulation is not a timed service. Chiropractors usually administer EMS for 15- to 30-minute sessions.
The F43. 8 code in the ICD-10 classification system represents "Other reactions to severe stress" and specifically addresses workplace-related stress conditions. This code has been split into two distinct categories: F43. 81 for prolonged grief disorder and F43.
Chiropratic CPT Codes List
Chiropractic focuses mainly on the musculoskeletal system and uses manual manipulation techniques, whereas physiotherapy focuses on physical impairments and disabilities and uses a variety of techniques, including exercise and manual therapy, to improve physical function.
Chiropractors and massage therapists may seem similar but are very different in terms of the approach they take. They both can help alleviate the pain that is disrupting your quality of life. But Chiropractic care address the spine and its alignment and massage therapists are more focuses on the muscles.
CPT Code 97014 refers to unattended electrical stimulation therapy. It's used in physical therapy to relieve pain, reduce inflammation, and promote healing—without the therapist being physically present during the procedure. Note: CPT 97014 is not recognized by Medicare.
98941 CPT code definition by American Academy of Professional Coders states that this code should be used to report chiropractic manipulative treatment (CMT) performed on 3-4 spinal regions by a qualified chiropractor.
Medicare and Spinal Decompression Therapy
Medicare typically covers medically necessary treatments, including some chiropractic services. However, spinal decompression therapy may not be explicitly covered unless it is part of a broader chiropractic care plan that addresses specific medical conditions.
Who can use CPT Code 97124? Physical therapists, occupational therapists, chiropractors, and other licensed practitioners can use CPT 97124 when performing therapeutic massage as part of a treatment plan.
However, you can never bill 97124 with 97140—and you cannot add any modifier to change this restriction, because these codes are mutually exclusive procedures, according to CMS.