Chiropractic billing services are outsourced companies that submit claims, follow up on denials and post payments for a fee, usually a percentage of collections, while chiropractic billing software lets your own team do that work for a monthly subscription; the right choice depends on your collections, staff time and how much control you want. Below: published software pricing, Medicare chiropractic billing rules, and a calculator that compares the fees.

Chiropractic claims have quirks that general medical billing guides skip. Medicare, for example, covers only manual manipulation of the spine to correct a subluxation, and claims for active treatment need the AT modifier. See the coding section below, then compare options and use the calculator.

Chiropractic billing services vs billing software

Billing companies typically charge a percentage of collections that varies by practice size and specialty (Physicians Practice, citing the Healthcare Billing and Management Association), so get written quotes and ask what is included. Ask for the clean claim rate, how denials are worked and who owns the data. For a deeper look, read our guide to choosing a chiropractic billing company and our overview of revenue cycle management for chiropractic practices.

Chiropractic billing software and services compared

Prices are from each vendor's own page in October 2026, exclude card processing, taxes and promotions, and can change. Vendor performance figures such as clean-claim or collection rates are self-reported, so ask any billing company to back them with your own payer mix. Compare other specialties in our top healthcare RCM companies guide.

Outsourced billing vs software cost calculator

Chiropractic billing and coding basics

Chiropractic billing turns documented care into compliant claims: verify eligibility and benefits, record SOAP notes that support medical necessity, assign ICD-10 diagnoses and CPT codes with modifiers, submit to the payer, then work rejections and denials and post payments. Our documentation tools and digital SOAP notes guide cover the documentation side, and the CPT and ICD-10 libraries list codes.

The First Coast Service Options code guide on the CMS Medicare Coverage Database states that 98940-98942 are not add-on codes, so you report only the highest applicable code; for example, five regions are reported with 98942 alone.

Medicare chiropractic billing. Medicare.gov says Part B covers only adjustments of the spine by a chiropractor to correct a subluxation, using the hands or a device called an activator, and that you pay 20% of the Medicare-approved amount after the Part B deductible. Medicare does not cover other services a chiropractor may order, such as X-rays, massage therapy or acupuncture. For active or corrective treatment, the AT modifier must be on the claim or it will be denied; maintenance therapy takes no modifier and should not carry AT. The date of initial treatment, exacerbation or reinjury goes in Item 14 of the CMS-1500, and an X-ray date, if used to determine the subluxation level, goes in Item 19.

Commercial payers set their own rules, so confirm visit limits, authorization and modifier policies for each plan.

Chiropractic payment processing and software with payments

Practices often pair billing with card processing and patient statements. Among the options above, ChiroSpring lists integrated payments (ChiroSpring Pay) and patient statements with online payment links on its plans, and ChiroTouch lists Payments in its Start plan. Check processing rates and contract terms separately, since they are not part of the subscription price.

How to choose

• Decide who will run billing: your own staff with software, or an outsourced team.
• Get quotes in writing, including what is covered and what costs extra.
• Confirm chiropractic experience: Medicare AT modifier rules, CMT codes, personal injury and workers' compensation claims.
• Ask for reporting: clean claim rate, denial reasons and days in accounts receivable.
• Check clearinghouse, ERA and eligibility fees, which can sit outside the subscription.
• Confirm HIPAA safeguards and who owns your data if you leave (HIPAA guide).

SPRY brings documentation, scheduling, eligibility and billing together for chiropractic and rehab clinics, starting at $79 per provider per month. See SPRY for chiropractic or book a demo.

Related reading: the ultimate guide to chiropractic billing and how to choose a chiropractic billing company.

Frequently asked questions

What are chiropractic billing services?

Chiropractic billing services are outsourced companies that handle claim submission, denial follow-up and payment posting for chiropractic practices, usually for a percentage of collections or a flat fee.

How much do chiropractic billing services cost?

Most billing companies charge a percentage of collections that varies by practice size and specialty, or a flat monthly fee. Ask for written quotes, and use the calculator on this page to compare a percentage fee with software pricing.

What is the difference between a billing service and billing software?

A billing service has its own staff do the billing for a fee. Billing software gives your team the tools to submit and track claims, usually for a monthly subscription, so you keep control but need someone to run it.

What CPT codes do chiropractors use?

The main chiropractic manipulative treatment codes are 98940 (1 to 2 spinal regions), 98941 (3 to 4) and 98942 (5), with 98943 for extraspinal treatment. Report only the highest applicable spinal code.

Does Medicare cover chiropractic care?

Medicare Part B covers only manual manipulation of the spine to correct a subluxation. After the Part B deductible you pay 20% of the Medicare-approved amount, and services such as X-rays, massage and acupuncture ordered by a chiropractor are not covered.

What is the AT modifier in chiropractic billing?

The AT modifier marks active or corrective treatment on Medicare chiropractic claims. It must be on the claim for active treatment, and it should not be used on maintenance therapy.

How much does chiropractic billing software cost?

Published prices in October 2026 include ChiroSpring at $149 to $299 a month, Jane at $59 to $99 a month with an insurance billing add-on, and SPRY from $79 per provider per month. ChiroTouch and Tebra use quotes.

Which chiropractic software includes payment processing?

ChiroSpring lists ChiroSpring Pay and ChiroTouch lists Payments in its Start plan. Compare processing rates and terms separately from the subscription.