Is the AT-modifier required for all spinal manipulation services to be reimbursed by insurances? I know that medicare requires the modifier for reimbursement and some payers are following suit. But, is it required across the board and if so by who? Thank you.
re: AT modifier use for spinal manipulation services
The AT modifier is generally used for the following, NOT for maintenance therapy.
* For use with procedure codes: 98940 - 98942.
* When the service is active/corrective treatment of the spine by hand or handheld device with the thrust or force of the device be manually controlled.
* When the result of chiropractic manipulation is expected to be an improvement in, or arrest of progression, of the patient's condition.
Due to the fact that Medicare generally sets the rules that are followed by other payers, I would certainly verify with your payer the proper usage and modifier requirements. Many Payers use CMS rules, for example, BCBS, UHC, EMI, and many other plans