Chiropractic CPT Codes 2026: Complete Guide to Billing Spinal Manipulation and E&M Services

Spinal Manipulation CPT Codes: 98940-98943

The four spinal manipulation CPT codes are differentiated by the number of spinal regions treated. CPT 98940 covers spinal manipulation of one to two regions; CPT 98941 covers three to four regions; CPT 98942 covers five regions; and CPT 98943 covers extraspinal manipulation. The five spinal regions are: cervical, thoracic, lumbar, sacral, and pelvic.

The most common CPT coding error in chiropractic billing is billing a higher-level code than the documentation supports. Documentation requirements for spinal manipulation codes include: the patient's presenting complaint and history; examination findings that support the diagnosis and the regions treated; the specific manipulation technique(s) used; the patient's response to treatment; and the plan for future treatment.

Evaluation and Management Codes for Chiropractors

Chiropractors can bill E&M codes in addition to or instead of spinal manipulation codes. The E&M codes most commonly used by chiropractors are: 99202-99205 for new patient office visits and 99212-99215 for established patient office visits. Billing both an E&M code and a spinal manipulation code on the same date of service requires the -25 modifier appended to the E&M code.

Automated CPT Code Suggestions in Pryme Practice

Pryme Practice's AI documentation system automatically suggests CPT codes based on the documented clinical findings. When a provider documents treatment of three spinal regions, the system suggests CPT 98941. When the documentation includes a significant evaluation component, the system suggests the appropriate E&M code with the -25 modifier. These suggestions significantly reduce the cognitive burden of code selection and the errors that result from it.