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Dynamic Chiropractic – February 1, 2014, Vol. 32, Issue 03

dynamicchiropractic.com >> Billing / Insurance / Records

More Money From Medicare This Year

By Editorial Staff

Medicare's 2014 Physician Fee Schedule increases the value of chiropractic current procedural terminology (CPT) codes 98940, 98941 and 98942 effective Jan. 1, 2014. The fee increases include a 2.2 percent increase for 98940 – Chiropractic Manipulative Treatment (CMT), spinal, 1-2 regions (work relative value units: 0.46 for 2014 vs. 0.45 for 2013); a 9.2 percent increase for 98941 – CMT, spinal, 3-4 regions (RVU: 0.71 for 2014 vs. 0.65 last year); and a 10.3 percent increase for 98942 – CMT, spinal, five regions (RVU: 0.96 in 2014 vs. 0.87 in 2013).

The American Chiropractic Association noted in a press release that the fee increase "comes after ACA provided CMS-appointed coding committees with key information about the physician-level work involved in these procedures." According to the ACA, increasing CPT code values has been an ongoing association priority that could now amount to upwards of $60 million in additional reimbursement revenue for doctors of chiropractic in 2014.

"[W]e are encouraged by this latest positive change and are committed to continuing our campaign to expand the availability and value of chiropractic in Medicare," said ACA President Keith Overland, DC. "We are also especially grateful to ACA Vice President Anthony Hamm, DC, and our research consultant Christine Goertz, DC, PhD, for their tireless efforts in helping the RUC-HCPAC to understand the high-quality physician-level treatment that doctors of chiropractic provide their patients."

The chiropractic profession is no stranger to Medicare reimbursement – particularly the annual threat of fee schedule reductions that has loomed for more than a decade. Congress has intervened, often at the 11th hour, to delay the annual cuts each year, while critics have lobbied for an alternative to the Sustainable Growth Rate (SGR) formula used to determine physician payments.

In May 2013, the House Ways & Means and Energy & Commerce Committees called for "fiscally responsible fundamental reform of the Medicare fee-for-service (FFS) payment system" and said they are "committed to developing such a reform proposal." According to the committees, reform would involve a complete repeal of the SGR formula as part of a three-phase reform process.


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