Deciphering the Medicare Fee cut Challenges for Chiropractic Billing

Chiropractors have been receiving 26 percent fee cut for some time, but still there is a lack of understanding of the impact of the cuts on chiropractic medical billing. The result is chiropractors are losing money but don’t clearly know how and why. The best way to understand the impact of Medicare fee cut on chiropractic medical billing is to start by understanding which of your chiropractic services are eligible for cuts.

Medicare only covers the treatments that involve manual manipulation of spine to correct dislocation of bones. This removes a handful of chiropractic services from the purview of cuts,  like acupuncture, physical therapy, x rays and so on – which are not covered by Medicare.

But it hardly reduces the number of chiropractors impacted as the impact of cuts will be wider than those paid by Medicare to include even those who are paid by third parties because third parties/private insurers calculate their reimbursement amounts based on the fee schedule followed by Medicare.       

Seen strictly from a financial standpoint, additionally chiropractors may lose two percent from their Medicare payments in cases where a non-participating chiropractor is involved (in consulting capacity, for example) in a treatment cycle.

In a possible relief to chiropractors, however, CMS considered paying chiropractors for Evaluation and Management (E/M) services. It’s surely an opportunity for chiropractors to offset the cuts, but what’s important to note here is it’s still at the stage of being considered – and will take time to come into effect if it does at all. And if it comes to pass, you have to deal with codes and related complexities to be paid separately for E/M services beyond CMT codes.

However, with or without separate payment for E/M services and despite the Medicare cuts, you can keep the financial health of your chiropractic practice buoyant by getting a few activities related to and around billing and coding correct.

MBC’s Revenue Management Consulting services can help you to gear up your revenue management cycle to meet the challenges and changing needs of Medicare reimbursement program. We will assess your current operations to spot areas that would require improvement in terms of processes and technologies and would help address those concerns by streaming up your existing processes and replace outdated applications with new and relevant ones.

However, if you don’t have an in-house billing and coding department, you can outsource your entire billing and coding responsibilities to us. Medicalbillerandcoders.com is the largest consortium of billers and coders in the US and we have been helping many big, small and medium sized chiropractors to improve their revenues.

MBC helps chiropractors be in greater control of their revenue and operations by:

·         Tracking incoming reimbursement payments to check whether they have been affected by cuts and if yes whether the deducted amount was expected to be deducted

·         Helping stay updated with new Medicare rules to ensure complete accuracy

·         Sending regular reports and also performing regular follow ups with payers


This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.


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