Chiropractic invoice template
Chiropractic invoice template is used by chiropractors and clinics to bill patients and third-party payers for adjustments, therapies, and related services. It should reference CPT codes (e.g., 98940–98942 for spinal manipulation), ICD-10 diagnoses, and support documentation for medical necessity. Proper line items reduce denials and support Medicare and commercial insurance compliance.
Chiropractic invoice template Sample
Chiropractic invoice template
123 Business Street, City, Country
Phone: (123) 456-7890
Email: contact@company.com
Chiropractic invoice template
Bill To:
Client Name
Client Address
Client City, Country
Phone: (987) 654-3210
Email: client@example.com
Invoice #: 12345
Date: 2024-10-10
Due Date: 2024-11-10
| Item | Description | Qty | Price | Total |
|---|---|---|---|---|
| Service A | Itemized service or product | 1 | $100.00 | $100.00 |
| Service B | Additional line item | 2 | $50.00 | $100.00 |
| Subtotal | $200.00 | |||
| Tax (10%) | $20.00 | |||
| Total Due | $220.00 | |||
An invoice should include your business or name, the customer’s details, the date and invoice number, and a line-by-line breakdown of what was provided. Including payment terms—such as due on receipt, Net 15, or Net 30—helps you get paid on time and keeps records clear for taxes.
Supporting resources
| Resource | Type | Description |
|---|---|---|
| ACA Coding Guidance | Trade association | American Chiropractic Association coding and documentation resources; CPT and Medicare billing guidance. |
| CMT CPT codes | Benchmark | 98940 (1–2 regions), 98941 (3–4 regions), 98942 (5 regions); add therapeutic exercise 97110, manual therapy 97140, modalities as applicable. |
| Medicare documentation | Government | Active/corrective care documentation, SOAP notes, and medical necessity; maintenance therapy not covered. |
| Invoice line items | Checklist | Date of service, CPT code, units, diagnosis (ICD-10), fee, and any patient responsibility or insurance applied. |
Frequently Asked Questions
- What CPT codes do chiropractors use for spinal manipulation?
- 98940 (1–2 regions), 98941 (3–4 regions), and 98942 (5 regions). Other common codes include 97110, 97112, 97140, and modality codes.
- Does Medicare cover chiropractic care?
- Medicare Part B covers medically necessary spinal manipulation to correct subluxation. Maintenance therapy is not covered; documentation must support active/corrective care.
- What should a chiropractic invoice include for insurance?
- CPT codes, ICD-10 diagnosis codes, date of service, units, fee per service, and patient/guarantor info. Match the narrative to your documentation to avoid denials.