$37.48
Use 98941 when three or four spinal regions are manipulated. Code 98942 requires documented manipulation in all five: cervical, thoracic, lumbar, sacral, and pelvic.
On this page
CMS RVU26D · Effective 2026-10-01
98942 Chiropractic adjustment Medicare reimbursement rates in Utah
Report chiropractic spinal manipulation at this level when treatment is documented in all five regions: cervical, thoracic, lumbar, sacral, and pelvic. Compare 98942 office and facility rates across CMS payment localities in Utah.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 98942 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$48.65
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$37.66
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Chiropractic manipulation
About 98942: Chiropractic spinal manipulation, five regions
Report chiropractic spinal manipulation at this level when treatment is documented in all five regions: cervical, thoracic, lumbar, sacral, and pelvic.
Chiropractic manipulative treatment at this level addresses all five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. A chiropractor performs the spinal adjustment, usually in an office, although it can also occur in a facility. The pelvic region includes the sacroiliac area. The visit qualifies only when manipulation, not merely examination, occurs in each of the five distinct regions.
Report one unit for the encounter when all five regions are manipulated; do not bill separate units for individual vertebrae or regions. Record each region treated and findings supporting care. For Medicare chiropractic coverage, document a spinal subluxation by x-ray or qualifying physical findings and use modifier AT for active corrective treatment; maintenance care is not covered. This procedure has a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for bilateral adjustments. CMS allows assistant-at-surgery payment only with documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 98942
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.94 · 63%
- Practice expense (office) RVU0.54 · 36%
- Malpractice RVU0.01 · 1%
983K
Medicare services in 2024 · #145 by national volume
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.
98942 compared with similar codes
Office rates for Utah, from the same CMS release.
$58.94
Code 98927 is osteopathic manipulative treatment of five or six body regions. Code 98942 is chiropractic manipulative treatment of all five spinal regions.
98943
No office rateChiropract manj xtrspinl 1/>
Code 98943 covers manipulation of extraspinal areas such as an extremity or the TMJ. Code 98942 covers spinal regions; both may be reported when both services are furnished and payer coverage allows.
$26.91
Code 97140 describes timed manual therapy rather than chiropractic spinal manipulation. Therapy to the same anatomical region is not separately reportable; Medicare does not cover 97140 furnished by a chiropractor.
Compare 98942 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Utah →
Office / nonfacility
$48.65
Facility
$37.66
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 98942 in Utah.
PPRRVU2026_Oct_nonQPP.csv
12,944
- Code
- 98942
- Physician work
- 0.94
- Practice expense
- 0.54
- Malpractice
- 0.01
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.94 | × 1.000 | 0.9400 |
| Practice expense | 0.54 | × 0.940 | 0.5076 |
| Malpractice | 0.01 | × 0.898 | 0.0090 |
| Total RVUs | 1.4566 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$48.65
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.94 | 1 |
| Practice expense | 0.54 | 0.94 |
| Malpractice | 0.01 | 0.898 |
(0.94 × 1 + 0.54 × 0.94 + 0.01 × 0.898) × $33.4009 = $48.65
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.94 | 1 |
| Practice expense | 0.19 | 0.94 |
| Malpractice | 0.01 | 0.898 |
(0.94 × 1 + 0.19 × 0.94 + 0.01 × 0.898) × $33.4009 = $37.66
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
98942 billing questions
How are the five spinal regions counted for this code?
The regions are cervical, thoracic, lumbar, sacral, and pelvic. Manipulation must be documented in all five; use 98941 if only three or four are manipulated.
When is modifier AT used on a Medicare claim?
Append AT when the manipulation is active corrective treatment of a documented spinal subluxation. Medicare does not cover maintenance manipulation.
Can an E/M visit be billed on the same day?
Same-day preoperative and postoperative care is included in the 0-day global period. Medicare does not pay chiropractors separately for E/M services; an eligible clinician reporting a significant, separately identifiable E/M service places modifier 25 on the E/M code.
Can an extremity adjustment be reported with five-region spinal manipulation?
Code 98943 may be reported for a separately documented extraspinal adjustment when payer coverage allows. Medicare does not cover extraspinal manipulation furnished by chiropractors.
Can 97140 be reported for manual therapy on the same date?
Manual therapy to the same anatomical region is not separately reportable with this manipulation. For a payer that covers both services, a distinct site may support separate reporting with modifier 59 or XS when the documentation and applicable edit permit it; Medicare does not cover 97140 furnished by a chiropractor.
What documentation supports billing this level?
List each of the five regions manipulated and the findings supporting treatment. For a Medicare claim, document the spinal subluxation, active treatment, and applicable treatment plan.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,94198929,,Osteopath manj 9-10 regions,A,,1.42,1.08,,0.29,,0.07,2.57,1.78,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94298940,,Chiropract manj 1-2 regions,A,,0.45,0.34,,0.09,,0.01,0.80,0.55,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94398941,,Chiropract manj 3-4 regions,A,,0.69,0.45,,0.14,,0.01,1.15,0.84,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94498942,,Chiropractic manj 5 regions,A,,0.94,0.54,,0.19,,0.01,1.49,1.14,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94598943,,Chiropract manj xtrspinl 1/>,N,+,0.45,0.31,,0.10,,0.03,0.79,0.58,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94698960,,Edu&trn pt self-mgmt nqhp 1,B,+,0.00,0.98,,0.98,NA,0.02,1.00,1.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94798961,,Edu&trn pt slf-mgmt nqhp 2-4,B,+,0.00,0.46,,0.46,NA,0.01,0.47,0.47,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985