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CPT & HCPCS Codes

CPT 98940: Chiropractic Manipulative Treatment, 1-2 Regions

Reviewed by the ImmediCare RCM team Updated 3 min read
Quick answer

CPT 98940 reports chiropractic manipulative treatment (CMT) of one to two spinal regions. It is untimed, billed once per encounter. In 2026 Medicare pays about $26.72 non-facility and $18.37 facility (national, before locality adjustment). Medicare covers only manual spinal manipulation to correct a subluxation.

Code type
Chiropractic manipulative treatment (untimed)
2026 Medicare
~$26.72 nf / ~$18.37 f
Timed?
No — once per encounter, by region count
Coverage
Medicare: manual spinal manipulation for subluxation only

What is CPT 98940 used for?

CPT 98940 is chiropractic manipulative treatment (CMT) of one to two spinal regions. It is the entry-level CMT code and is untimed — billed once per encounter based on how many regions were manipulated, not how long the visit lasted. The CMT codes include a brief pre-manipulation assessment, so a separate low-level exam is generally not billable on top.

How does the region count work?

Medicare recognizes five spinal regions — cervical, thoracic, lumbar, sacral, and pelvic. The three CMT codes escalate by region count:

  • 98940 — 1 to 2 regions.
  • 98941 — 3 to 4 regions.
  • 98942 — all 5 regions.

Document each region examined and manipulated. Billing 98941 or 98942 without documentation supporting the higher region count is a frequent audit finding.

What does Medicare cover, and why does the AT modifier matter?

Medicare Part B covers only manual spinal manipulation to correct a subluxation — no exams, imaging, or physical modalities from a chiropractor. Active or corrective care must carry the AT (acute treatment) modifier; maintenance care is not covered, and omitting AT causes Medicare to treat the visit as non-covered.

Note: The AT modifier attests active treatment but does not by itself guarantee payment — the record must still show a subluxation and a reasonable expectation of functional improvement. Give the patient an ABN when continued care shifts to maintenance.

Can you bill 97140 with 98940?

Manual therapy (97140) is bundled with CMT under NCCI edits. When manual therapy is performed on a different region than the manipulation, a modifier 59 can unbundle it — but only with documentation of the separate region and distinct service. Verify the allowed amount and your locality-adjusted rate in the Medicare fee calculator. Because Medicare covers only the manipulation, tie every claim to a documented medical necessity for subluxation correction.

Check your jurisdiction: Coverage, frequency, and documentation rules here reflect national guidance. Your MAC may enforce a different Local Coverage Determination — confirm your jurisdiction's active LCD before billing. Dollar amounts shown are national baselines; your locality's GPCI-adjusted rate will differ.

Frequently asked questions

Medicare recognizes five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. 98940 covers manipulation of 1-2 regions, 98941 covers 3-4, and 98942 covers all 5. Count the regions actually manipulated and documented, not the number of segments.

Medicare Part B covers only manual manipulation of the spine to correct a subluxation demonstrated by exam or imaging. It does not cover exams, X-rays, therapies, or maintenance care from a chiropractor. Active treatment claims need the AT modifier; without it, Medicare treats the service as non-covered maintenance.

The 2026 national non-facility rate is about $26.72 and facility about $18.37 before locality adjustment. Medicare pays 80 percent after the deductible. Because Medicare covers only the manipulation, everything else in a chiropractic visit is typically the patient's responsibility.

IC

Reviewed by the ImmediCare Solutions RCM team

Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.

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