Insurance & Medicare

Insurance/Medicare Documents

Please utilize this list of compiled resources for chiropractors.

Documentation Guidance

Avoid Medicare denials by providing proper documentation. Click here to dowload.

Medicare Fee Schedule

Click here to download the 2024 fee schedule

Click here to download the 2023 fee schedule

Click here to download the 2022 fee schedule

Click here to download the 2021 fee schedule

Click here to download the 2020 fee schedule

Click here for the 2019 fee schedule  

Medicare Chiropractic Policy

Click here for codes, modifiers and guidelines.

Fee For Service Advance Beneficiary Notice of Noncoverage

Click here for the link.

Medicare Parts A & B Appeals Process

Click here to download.

 

PI Forms (click)

 

2017 ICD-10-CM Diagnosis Codes (click)

 

ICD-10 Implementation Manual (click)

  

HIPAA Final Rule (click)

 

Medicare 25-Visit Review Tips

After the patient's 25th visit in a 12-month period, Medicare will automatically deny the visit, forcing DCs to file an appeal and send in records to substantiate the medical necessity. Read more.

 

Tips for Complying with a Medicare Review

Many doctors of chiropractic have probably received a request for records on one or more Medicare patients from CAHABA, the contractor/payor for Medicare in Georgia. It is vitally important to all of us that you comply with this request and that your records meet the required standards to properly document the medical necessity of your treatment. These reviews are mandated by CMS to all local carriers to assure claims are properly paid. If your records do not substantiate your care, the claim may be denied, or if already paid, you may be required to refund the money. Read more

Should You Participate in the Quality Payment Program?