Can Chiropractors Bill for Physical Therapy Services?

Chiropractors don’t just adjust spines anymore. Many integrate strength exercises, balance training, and even modalities like e-stim into treatment. But here’s where things get murky: are you allowed to bill for those physical therapy services?

That depends on who’s paying and what your state allows. Billing for physical therapy codes as a chiropractor isn’t as simple as adding CPT 97110 or 97530 to the claim. It takes more than knowing the chiropractor billing codes. You need clear documentation, modifier accuracy, and a deep understanding of both federal and commercial payer rules.

This blog clears up the confusion. You’ll learn what’s billable, what’s not, and how to protect your revenue while keeping your care compliant. 

What is Under Chiropractors’ Scope of Practice

Chiropractors are licensed to diagnose, treat, and manage neuromusculoskeletal conditions. Their services often include spinal manipulation, soft tissue techniques, therapeutic exercises, and patient education.

But when it comes to physical therapy services, scope of practice becomes a gray area. In some states, chiropractors can provide and bill for a wide range of therapy services as long as the care is medically necessary and within their license. In others, those same services fall under a physical therapist’s exclusive domain.

The difference comes down to how each state defines what chiropractors can do and whether “physical therapy techniques” are listed under chiropractic rules or restricted to PTs.

Understanding your scope is more than legal hygiene. It decides what you can bill, what you must refer, and what you risk if you overstep.

What Constitutes Physical Therapy Services?

Physical therapy covers a broad range of interventions focused on restoring movement, strength, and function including:

• 97110 – Therapeutic exercise
• 97112 – Neuromuscular re-education
• 97530 – Therapeutic activities
• G0283 – Electrical stimulation

Each of these codes has specific requirements based on time, skill, and medical necessity. PT services aren’t just “movement.” They’re structured, goal-driven, and documented with outcomes in mind.

Licensed physical therapists are trained and certified to deliver this care based on standardized protocols. Chiropractors who want to bill these services must prove they meet the same standards. Even if they’re not PTs.

That means showing the intervention was active, required clinical skill, and supported a functional goal. If it’s not skilled, it’s not reimbursable.

Rules and Regulations

Every therapy code comes with strings attached. The most common ones billed by chiropractors which include 97110, 97112, 97530, G0283 must meet three requirements: they must be skilled, time-based, and clearly separate from manipulation.

That means showing how each session progressed, what the clinical goal was, and why it required your hands not a YouTube video.

• Medicare: The only covered chiropractic service is spinal manipulation for subluxation, coded 98940 to 98942. Anything else, including therapy codes, is statutorily non-covered. If submitted, they must include modifiers GP (to route through therapy edits) and GY (to flag as excluded). This allows secondary payers to respond. CMT codes must include AT if the care is active; no AT = maintenance = automatic denial.
  
• Commercial payers: Some will reimburse therapy services if your state scope allows it. But expect documentation requirements: time per code, measurable goals, and separation from adjustment services.

Can Chiropractors Legally Bill for Physical Therapy Services?

The answer is: sometimes. Chiropractors can bill PT codes under commercial insurance if three things align:

1. Your state scope permits it
2. Your payer allows it
3. Your documentation proves it

For example:

• California allows chiropractors to use “physical therapy techniques” as part of their treatment plan.
• Washington mandates equal reimbursement for certain physical medicine codes, regardless of provider type.

But other states may limit these services to licensed PTs. That’s where chiropractors get stuck.

If you’re billing therapy codes without clear legal standing or without documenting clinical skill, you’re taking a risk. Payers have systems in place to flag repeated 97110s with no measurable outcome, or notes that mirror last week’s.

Clean claims need clean notes. Know your state. Know your payer. And never assume yesterday’s rules still apply today.

Challenges and Risks for Chiropractors Billing Physical Therapy

If you bill physical therapy codes without the right foundation, you’re exposed to more than denials. You’re looking at red flags for audits, repayment demands, or worse: fraud allegations.

• Medicare reviews claims for signs of maintenance care, overuse of AT, or therapy billed without a GP or GY modifier. Even one incorrect use of 97110 with the wrong modifier can trigger probe reviews.
• Commercial plans may also limit how many therapy visits a patient can use each year. If you bill therapy codes as a chiropractor, those visits may count against the PT cap even if the patient never saw a PT.

That creates tension with patients, lost trust, and out-of-pocket surprise bills.

The biggest risk? Copy-paste documentation. Payers want to see clinical change, not templated fluff. You need to show progress, intent, and differentiation. Repeating notes puts your whole clinic at risk.

How Chiropractors Can Comply with Requirements

Success in billing PT services starts with clarity: on rules, codes, modifiers, and documentation.

Here’s the roadmap:

1. Align with your state board. If your scope includes “physical medicine techniques,” you’re likely in the clear.
2. Check each payer’s policy. Don’t assume coverage just because the EHR lets you select the code.
3. Document like it matters. Each CPT code must show minutes spent, skill delivered, and goal addressed. Example:  “Therapeutic resistance training for shoulder abduction, 3 sets of 15, to restore ROM for overhead reach.”
4. Apply modifiers correctly. Add GP for therapy; if it’s Medicare and not covered, include GY too. For active manipulation, use AT.
5. Train your team. Update templates. Separate CMT visits from therapy-heavy sessions when possible to avoid visit-cap overload.
6. Audit monthly. The best defense is consistency.

Final Comments

Yes, chiropractors can bill for physical therapy services if the law, payer, and documentation all support it.

• Medicare only covers spinal manipulation codes (98940–98942). Anything else, like therapeutic exercise or neuromuscular re-ed, is statutorily non-covered.
• Commercial insurers may pay for PT services if your state scope allows it and your notes show skilled, time-based care.

Modifiers matter. Documentation matters more. Chiropractors who understand the rules don’t just avoid denials, they grow. They expand services, retain patients longer, and keep their income audit-proof. Don’t leave that to chance. Check your state board. Ask your payer. And when in doubt, document like you’re explaining it to an auditor. Because one day, you might be.

If you’re unsure whether your therapy billing lines up with the rules, we’ll check it for you. For free. Send us 5 de-identified claims. We’ll map out what’s working, what’s risky, and how to tighten up fast. Contact us to get your free billing audit.

FAQs

Can chiropractors perform physical therapy?

In many states, yes. But if it falls within their scope and is delivered as a skilled service. But they must document it accordingly.

What should chiropractors do if unsure about billing?

Check state law, payer rules, and consult with a billing compliance expert before submitting claims.

How can patients verify correct billing for PT services?

Ask the provider for CPT codes used and call the insurer to check how they count against your benefits.