Chiropractic AT modifier requirement delayed until Oct. 1
July 13 update: This initiative has been pushed back to October 1.
March 13 update: We have delayed the date that Priority Health will begin requiring that the AT (acute treatment) modifier must be appended to chiropractic CPT codes 98940, 98941 and 98942. Originally this requirement was scheduled for March 1, but the new date is now July 1, 2018.
As a reminder, Priority Health is updating their billing requirements for chiropractic services. In order to accurately identify chiropractic services that are covered according to our Rehabilitative & Habilitative Medicine Services medical policy, until July 1, 2018 the AT (acute treatment) modifier should be appended to chiropractic CPT codes 98940, 98941, 98942 for all products. This requirement has already been in effect for Medicare claims, and we are now expanding it to all products.
AT modifier update
The AT modifier must be used on claims when providing active/corrective treatment to treat acute or chronic subluxation.
The AT modifier must be documented accordance with the Centers for Medicare & Medicaid Services Medicare Benefit Policy Manual, Chapter 15, Section 240, when submitting claims.
Claims for CPT codes 98940, 98941, 98942 that are not appended by the AT modifier will be interpreted as "maintenance" or "custodial" services and will be denied for non-coverage per our policy.
For more information
See the Provider Center > Procedures & services > Medical/surgical > Manipulations