2026 Chiropractic Billing & Payment Updates

Compliance, Documentation, and Revenue Protection in 2026

Table of Contents

Unlike therapy services, 2026 does not introduce major payment expansions for chiropractic care. However, documentation scrutiny, modifier compliance, and payer enforcement continue to intensify, making operational discipline more important than ever.

1. Medicare Coverage for Chiropractic Services in 2026

Medicare coverage for chiropractic services remains unchanged and limited in 2026.

Covered services continue to be restricted to:

  • CPT 98940, 98941, and 98942
  • Coverage applies only to active treatment for spinal subluxation
  • Maintenance care remains non-covered under Medicare
What this means for you:
There is no expansion of covered services. Revenue stability depends on accurate coding, proper modifiers, and defensible documentation.

2. Medicare Payment Rates – 2026

  • Chiropractic services benefit from the overall Medicare conversion factor increase finalized for 2026
  • Payments for 98940–98942 may see a modest increase, consistent with the general Physician Fee Schedule update
What this means for you:
While payment increases are limited, high-volume practices may experience a small positive impact, provided claims are billed and documented correctly.

3. AT Modifier Compliance (High Audit Risk Area)

  • The AT modifier remains mandatory to indicate active treatment
  • Claims submitted without AT are routinely:
    • Denied
    • Recouped during post-payment audits
What this means for you:
The AT modifier is effectively a statement of medical necessity. Improper use—especially for maintenance care—is one of the most common audit findings in chiropractic practices.

4. Documentation Expectations (Increasing Scrutiny)

CMS and Medicare Administrative Contractors continue to focus on:

  • Clear distinction between active vs maintenance care
  • Documentation of:
    • Subluxation (location and severity)
    • Functional improvement
    • Treatment goals and response to care
    • Evidence that ongoing care is reasonable and necessary
What this means for you:
Repetitive notes, identical treatment plans, or lack of measurable progress significantly increase audit and recoupment risk.

5. Therapy and Adjunct Services (Non-Covered by Medicare)

Adjunct services such as:

  • Therapeutic exercises
  • Modalities
  • Massage therapy

remain non-covered under Medicare when billed by chiropractors

What this means for you:
  • Be billed as non-covered
  • Be supported by proper ABNs
  • Be tracked carefully to avoid improper Medicare billing

6. Commercial Payers & Medicare Advantage Plans

  • Commercial and Medicare Advantage plans continue to:
    • Tighten visit limits
    • Enforce prior authorization
    • Apply medical necessity reviews more aggressively
  • Post-payment audits and retrospective denials are increasing
What this means for you:
Payer-specific rules must be followed closely, as Medicare Advantage plans often apply stricter standards than traditional Medicare.

7. Patient Responsibility & Collections

The Medicare Part B deductible increases to $283 in 2026

What this means for you:
Higher patient responsibility early in the year may affect collections. Clear financial communication and point-of-service collections are essential.

Key Takeaway

While 2026 does not bring expanded Medicare coverage for chiropractic services, it reinforces a familiar theme:

Revenue protection depends on compliance, not volume.

Practices that:

will be best positioned to avoid denials, audits, and recoupments.

Our team will continue to support you with:

Please contact us if you would like a practice-specific chiropractic billing impact review or assistance strengthening your compliance workflows for 2026.

In Touch Billing Success Stories and Track Record

We have helped grow thousands of private practices over the years with a combination of software, workshops, and training programs. We recognize that basic elements like an EMR, billing software and a clearing house by themselves do not build a successful practice. They are just components of the bigger picture.

What you need is a billing service and a team that can help you with compliance and clinical documentation requirements. When you put great software in the hands of outstanding, dependable clinicians and billers, you’ll build a successful practice.

In December 2025 alone, our billing software has been used to process over $1 billion in collections and millions of insurance claims from thousands of payers in every state across the country. We are based in Denville, NJ and our billing staff is located in the United States and overseas, to help you lower your costs and maximize your revenue.

In 10 minutes, we’ll show you how In Touch Billing can slash your billing costs and boost revenue.

Schedule this no-obligations call. Ask for a FREE billing audit to learn new ways to increase revenue and reduce denials.

SCHEDULE MY BILLING STRATEGY CALL

In 10 minutes, we’ll show you how In Touch Billing can slash your billing costs and boost revenue.

Schedule this no-obligations call. Ask for a FREE billing audit to learn new ways to increase revenue and reduce denials.

SCHEDULE MY BILLING STRATEGY CALL

Copyright © 2026 In Touch Billing. All rights reserved.