Use of the AT modifier for Chiropractic Billing (New Information Along with Information in MM3449)
The Active Treatment (AT) modifier was developed to clearly define the difference between active treatment and maintenance treatment. Medicare pays only for active/corrective treatment to correct acute or chronic subluxation. Medicare does not pay for maintenance therapy. Claims should include a primary diagnosis of subluxation and a secondary diagnosis that reflects the patient's neuromusculoskeletal condition. The patient's medical record should support the services you are billing. Related MLN Matters Article SE1601discusses those medical record documentation requirements.
MLN Matters® Number: SE1602 Related Change Request Number: N/A DisclaimerThis article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2015 American Medical Association. All rights reserved.Page 2 of 5 Be aware of these policies along with any Local Coverage Determinations (LCDs) for chiropractic services in your area that might limit circumstances under which Medicare pays for active/corrective chiropractic services.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 16, 2016
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