Forum - Questions & Answers

Sep 22nd, 2020 - Coding&Thriving

Manipulation Therapy & Habilitative/Rehabilitative Services

Hello all,

I'm trying to locate a definitive source that either supports or refutes appending modifiers -96 (hab) or -97 (rehab) to manipulation treatment codes (98925-98943), or anyone that has experience with chiropractic/osteopathic coding & billing.

From what I can infer from my research modifiers -96 & -97 are applicable to therapy/modalities, but I've been unable to find anything about adding these modifiers to distinguish the two among manipulation treatments.

Also, I'm viewing this within the scope of Marketplace/Exchange coverage which list hab & rehab as EHB. So for states that have manipulation therapy under both benefits, is there a coding standard of differentiation?

Thank you for your time!

Oct 5th, 2020 - ChrisW   256  1 

re: Manipulation Therapy & Habilitative/Rehabilitative Services

What's the Difference?

Habilitative (modifier 96): services that help a person DEVELOP skills or functions they didn't have before.
Rehabilitative (modifier 97) services that help a person RESTORE functions that have become either impaired or lost.

This information is covered in an article written by Wyn Staheli for ChiroCode, you can view it here. Find-A-Code also has a TOPIC page for Chiropractic where her articles are FREE.

Using Modifiers 96 and 97

Q/A: Should I be Using Modifier 96 on PT Claims?

Requirements may vary from payer to payer, Here are a few examples:



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