Chiropractic manipulative treatment of three or four spinal regions during one encounter, the most common level when neck, mid back, and low back are adjusted together.
- Medicare
- $38.41
- Work RVU
- 0.69
- Global, days
- 0
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Level of subluxation for each spinal region treated, tied to the matching M99.0x diagnosis
- PART findings: pain, asymmetry or misalignment, range of motion change, and tissue or tone change
- Treatment plan with goals, frequency, and expected duration
- Progress toward goals at each visit, showing the care is active and not maintenance
- Regions actually adjusted that day, which drive the code level
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
98941 reports spinal manipulation of three or four of the five spinal regions (cervical, thoracic, lumbar, sacral, pelvic). It is the workhorse chiropractic code, which is also why payers watch it. If most of a provider's visits are 98941, expect a utilization review.
For Medicare, each region adjusted needs a documented subluxation and its own M99.0x code. Billing 98941 with a single lumbar subluxation diagnosis is a common reason for a downcode to 98940. The AT modifier is required for active treatment. Maintenance care is not covered, so use GA with a signed ABN when you expect a denial, or GZ when no ABN is on file.
In a multispecialty ortho group, check that the chiropractor's notes do not overlap physical therapy billed the same day for the same region without clear separate goals.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.69) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.15) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.69 |
| Practice expense RVU | 0.45 |
| Malpractice RVU | 0.01 |
| Total RVU | 1.15 |
| Medicare national rate | $38.41 |
| Global period | 0 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $38.41 |
HOPD (APC 5811) Hospital outpatient department | $22.06 |
Common denial reasons
The recurring reasons claims for CPT 98941 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Missing AT modifier on Medicare claims for active corrective treatment
- Primary diagnosis is not a subluxation code (M99.0x) when Medicare requires it
- Notes read as maintenance care with no functional improvement
- Region count does not support the code billed
- Commercial plan visit limit for chiropractic exhausted
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How many regions are required for CPT 98941?
02Why was 98941 reduced to 98940?
03Can a chiropractor bill an E/M with 98941?
04What does the GA modifier mean on chiropractic claims?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the findings for each spinal region adjusted and the patient's progress against the plan, which is what reviewers look for on 3 to 4 region claims.
See how Mira captures CPT 98941 documentation