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December 4, 2013 >> Billing / Insurance / Records

CMS to Significantly Increase Value of Chiropractic CPT Codes in 2014

The American Chiropractic Association (ACA) has learned that the Centers for Medicare and Medicaid Services (CMS) will increase the value of Chiropractic Manipulative Treatment (CMT) CPT codes up to 10 percent in the 2014 Physician Fee Schedule beginning Jan. 1. The change comes after ACA provided CMS-appointed coding committees with key information about the physician-level work involved in the procedures.

The increase in CMT code values is an important step forward for the profession, resulting from ACA's long campaign to expand and increase the value of chiropractic services in Medicare. It was in late 2012 that ACA representatives presented data from a random profession-wide survey on the physician work inherent in CMT codes 98940, 98941 and 98942 to the American Medical Association's RVS Update Committee (RUC) Health Care Professionals Advisory Committee Review Board (HCPAC). The RUC-HCPAC subsequently recommended an increase in the Relative Value Units (RVUs) for each of the CMT codes in 2014, which CMS accepted.

The new values, outlined below, will be used to calculate the allowable payment for each CPT code that doctors of chiropractic bill:

Long Descriptor CY 2013
CY 2014
Work RVU
Percent Increase
from 2013
98940 Chiropractic Manipulative Treatment (CMT);
Spinal, 1-2 regions
0.45 0.46 + 2.2%
98941 Chiropractic Manipulative Treatment (CMT);
Spinal, 3-4 regions
0.65 0.71 + 9.2%
98942 Chiropractic Manipulative Treatment (CMT);
Spinal, 5 regions
0.87 0.96 + 10.3%

"At ACA, we are encouraged by this latest positive change and are committed to continuing our campaign to expand the availability and value of chiropractic in Medicare," said ACA President Keith Overland, DC. "We are also especially grateful to ACA Vice President Anthony Hamm, DC, and our research consultant, Christine Goertz, DC, PhD, for their tireless efforts in helping the RUC-HCPAC to understand the high-quality physician-level treatment that doctors of chiropractic provide their patients."

Source: American Chiropractic Association


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