How to report Chiropractic Manipulative Treatment

CMT is a form of manual treatment to influence joint and neurophysiological function.

When similar or identical procedures are performed, but are qualified by an increased level of complexity:

• Only the definitive or most comprehensive service performed should be reported
• Only one CMT service of the spinal region (procedures 98940-98942) or extraspinal region (98943) is eligible for payment on a single date of service.
• Payment is limited to one clinically indicated and medically necessary physical medicine modality or procedure code per patient, per date of service.
• Payment is allowed for one clinically indicated and medically necessary extraspinal manipulation code (i.e., 98943-51) in combination with a spinal manipulation code (i.e., 98940, 98941, or 98942) per date of service.

The chiropractic manipulative treatment codes include a pre-manipulation patient assessment. Additional E/M services may be reported separately using modifier 25, if the member’s condition requires a significant separately identifiable E/M service, above and beyond the usual pre-service and post-service work associated with the procedure.

When multiple procedures are performed at the same session by the same provider, the modifier 51 may be appended to the additional CPT codes (excluding E/M codes).

Refer to the Chiropractic Modalities section for a complete listing of CPT physical medicine modality and procedure codes