There is no question that instrument assisted adjustments are a win-win for DCs. Not only are they able to deliver the same amount of thrust with far less force by using an instrument instead of a manual adjustment, there is less risk of injury to the patient, as well as less wear and tear on the DC.
Instrument assisted adjusting can allow DCs to not only expand the scope of their practice, but it also allows them to see more patients during a given day, thereby adding to their bottom line. All in all, instrument adjusting can do wonders for a chiropractic practice.
However, one area of instrument adjusting that may still leave DCs scratching their heads is how best to bill for it, particularly for Medicare.
Many DCs may decide to hire a coding specialist to do that part of the job for them. However, some DCs may have very small practices, just be starting out in business or simply want to keep as much hands on the business side of things as possible. Even those DCs who do hire somebody to do their coding for them are well served to understand the basics of coding, particularly when it comes to instrument adjusting.
What does CMS allow for chiropractic care?
At its most basic level, Medicare covers chiropractic for manual adjustments to treat spinal, vertebral sublaxations. The covered treatment must provide a direct therapeutic benefit for the patient, with a reasonable expectation of improvement or recovery. This means that regular wellness adjustments cannot be covered under Medicare.
CMS states: “Coverage extends only to treatment by means of manual manipulation of the spine to correct a subluxation provided such treatment is legal in the State where performed.”
What does CMS allow for instrument adjusted care?
Medicare allows for instrument adjusted care, provided that the instrument being used is manually, rather than electronically, activated.
CMS states: “In addition, in performing manual manipulation of the spine, some chiropractors use manual devices that are handheld with the thrust of the force of the device being controlled manually.”
However, Medicare does not allow for any additional coverage for using an instrument to perform adjustments, nor will it allow DCs to charge for the instrument.
CMS adds: “While such manual manipulation may be covered, there is no separate payment permitted for use of this device.”
The take-home message for DCs is that if they decide to upgrade to using instrument adjusting devices, they will still be able to bill Medicare for such treatments. However, they cannot bill extra simply because the adjustment was performed with an instrument, rather than with just the hands.
