Chiropractic Services for Acute Treatment
Governs Humana Medicare Advantage billing requirements and reimbursement guidelines for chiropractic services rendered for acute treatment under the Medicare Part B benefit; affects providers submitting claims for Humana MA members.
No material clinical or coverage changes in this revision.
Medicare Part B Coverage Requirements
Medicare Part B chiropractic coverage requirements
Covered when ALL of the following are met:
ALL of the following
- Service is a chiropractic service consistent with applicable CMS guidance (same diagnoses as Original Medicare).
- Service is billed with a covered chiropractic CMT CPT code (CPT 98940 - 98942).
See coding section for code definitions.
- Service is rendered for acute treatment purposes (acute treatment qualification required under Medicare Part B).
- Provider reports modifier AT on claims for CPT 98940 - 98942 to indicate the service meets Medicare Part B acute treatment qualifications.
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