Posted by Team KMCU on Apr 4, 2025
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Is 98941 Your Go-To Code? Medicare Might Be Watching
Hot Topics from the KMC University HelpDesk
In this edition of the KMC University HelpDesk, Yvette shares eye-opening Medicare error statistics that directly impact chiropractic offices. Despite ongoing education, chiropractors continue to top the list for improper Medicare payments—primarily due to insufficient documentation. Yvette walks you through recent Medicare data, error rates, and the heavy scrutiny around code 98941.
She also explains how you can proactively check your own billing patterns, avoid being flagged as an outlier, and improve your documentation to protect your practice from audits and denials. Whether you’re new to Medicare or a seasoned provider, this video is a must-watch for maintaining compliance and staying off the radar.
Comments on Why Chiropractors Are Top of the Medicare Error List
Are chiropractic codes with or without modifiers covered or not covered? Why do insurances reprice codes to zero by the network? I currently work for a chiropractic office and helping with their billing. Codes are not being paid for when services are rendered. Why?
Gayle,
This is a great question! The only way you are truly going to know if Chiropractic is a covered service is by your Insurance Verification. It sometimes will depend upon whether you are In Network or not. Looking at your Medical Review Policy for those Payers, especially Medicare, will let you know what modifiers need to be in play for Chiropractic. For instance, Medicare requires an AT modifier on the 9894x codes when the patient is in Active Treatment, once they go onto Maintenance Care, a GA Modifier will need to be attached to show that you obtained an ABN. We would love to bring you under the care of KMC University, I would definitely recommend scheduling a Discovery Assessment today to see how we can make that happen:
https://kmcuniversity.com/free-discovery-assessment