Chiropractic

Fee Schedule for Examinations and Consultations (September 23, 1998)

Chiropractic Services (November 29, 1995)

SERVICE FEE MEMORANDUM

MS-97-98-37

DATE: September 23, 1998

RE: Fee Schedule for Examinations and Consultations

Effective immediately this Memo reflects code changes, but no rate changes. Written reports must be furnished. Special medical forms may be used in lieu of a narrative report.

00044 Podiatric Services $45.00

00045 Physical Therapy Evaluation 60.00

00046 Occupational Therapy Evaluation 60.00

00047 Diagnostic General Medical Examination 50.00

with routine history and written report

Chiropractic procedures 00042 and 00043 have been deleted. Refer to Relative Value Schedule (RVS), Medicine Section, 98940, 98941, and 98942 for fees. Refer to SERVICE FEE MEMORANDUM MS-94-95-12 (UPDATED AND ADDENDUM), November 29, 1995, Chiropractic Services for guidelines.

Refer to the RVS, Evaluation and Management Section, for allowable rates for Consultations, Office Visits, Hospital Visits, Home Visits, and Critical Care Services. Refer to RVS, Medicine Section, 92002, 92004, 92012, and 92014 for Ophthalmology Consultations. Refer to Dental Fee Schedule for Oral Examinations.

DATE: November 29, 1995

RE: Chiropractic Services

DVR coverage of chiropractic services will continue to be limited to treatment of the spine to correct a subluxation demonstrated by x-ray to exist. Treatment must be with the hands and/or the chiropractic activator which is a small hand-held mechanical device used to make the adjusting thrust. For DVR purposes, subluxation covers incomplete dislocation, off-centering, misalignment, fixation, and abnormal spacing of the vertebrae.

For allowable fees, reference CPT codes 98940, 98941, or 98942 in RVS, Medicine.

DVR will not reimburse for the activator device nor allow an additional fee for its use. No reimbursement may be made for x-rays taken and interpreted by a chiropractor. Other diagnostic or therapeutic services performed by a chiropractor, such as diathermy (CPT code 97024), ultrasound (CPT code 97035), traction (CPT codes 97122 and 97012), and other physical medicine modalities/procedures (CPT codes 97700 to 97799) are not covered.