Billing code 98940: Chiropractic adjustmentMedicare rate & RVUs in Texas
Report chiropractic spinal manipulation of one or two regions when those regions are adjusted during an encounter to treat a documented spinal subluxation.
Medicare pays $25.67–$27.37 for 98940 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 98940 covers
This service involves chiropractic adjustment of one or two of the five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. A patient with low back pain might receive treatment in the lumbar and pelvic regions; a patient with neck pain might receive treatment in the cervical region. Doctors of chiropractic typically perform the service in an office. For Medicare coverage of care furnished by a chiropractor, the manipulation must be directed at correcting a spinal subluxation.
Count distinct regions adjusted, not individual vertebral segments; manipulation of three or four regions is reported with 98941. Medicare requires evidence of subluxation by x-ray or physical examination. Examination findings use PART: pain or tenderness, asymmetry or misalignment, range-of-motion abnormality, and tissue or tone change. Document the regions treated, findings, treatment plan, and progress; append modifier AT for active or corrective treatment, not maintenance care. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. CMS permits assistant-at-surgery payment only with documented medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 98940 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$25.67 to $27.37
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $27.37 | $18.54 |
| Beaumont | $25.67 | $18.08 |
| Brazoria | $26.67 | $18.39 |
| Dallas | $26.76 | $18.45 |
| Fort Worth | $26.65 | $18.42 |
| Galveston | $26.70 | $18.41 |
| Houston | $26.89 | $18.60 |
| Rest Of Texas | $26.11 | $18.18 |
How the 98940 rate is calculated
Each of 98940’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 98940
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.45Practice expense 0.34Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 98940
The CMS indicators that decide how 98940 is paid alongside other services.
CMS payment indicators · 98940
Chiropractic adjustment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
98940 compared with similar codes
Compare codes
98940 vs 98941 vs 98925 vs 98943: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 98941Chiropractic adjustment
- Choose 98941 when three or four spinal regions are adjusted at the visit; 98940 covers one or two.
- 98925Osteopathic manipulation
- 98925 describes osteopathic manipulation of one or two body regions, which may include regions outside the spine. 98940 describes chiropractic manipulation counted across five spinal regions.
- 98943Chiropract manj xtrspinl 1/>
- 98943 covers extraspinal regions, such as extremities or the rib cage. 98940 covers one or two spinal regions.
98940 billing questions
How are spinal regions counted to choose between 98940 and 98941?
Count the regions actually adjusted among cervical, thoracic, lumbar, sacral, and pelvic. One or two regions is 98940; three or four is 98941. Multiple vertebral levels within one region count as one region.
When is modifier AT required?
Medicare expects AT when chiropractic manipulation is active or corrective treatment of a subluxation. Without AT, Medicare treats the claim as maintenance therapy; AT alone does not establish medical necessity.
Can a chiropractor bill a separate E/M visit on the same day?
Medicare does not separately pay chiropractors for E/M visits. The routine assessment before manipulation and same-day postoperative care are included in 98940.
What documentation supports subluxation for Medicare?
Subluxation must be demonstrated by x-ray or physical examination. The examination route requires at least two PART elements, including asymmetry or misalignment or a range-of-motion abnormality; document the treatment plan and measurable goals.
Can 98940 be billed with extraspinal manipulation?
98943 describes manipulation of extraspinal regions, such as an extremity or the rib cage, and may be reported when separately performed. Medicare does not cover chiropractic extraspinal manipulation furnished by a chiropractor.
Should modifier 50 be used if both sides of the spine are adjusted?
No. Report 98940 once for manipulation of one or two spinal regions during the encounter, regardless of which sides are treated; modifier 50 is inappropriate.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 98940 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →