New Chiropractic and Osteopathic Treatments Policy

Blue Cross Blue Shield of North Dakota (BCBSND) continually develops and revises coding and reimbursement policies and resources in response to rapidly changing medical technology and updates to the coding sets.

Our commitment is to update the provider community as coding and reimbursement policies and guidelines are added, adopted, and/or revised.

The following coding and reimbursement policy has been updated:

• Chiropractic Services
  • Name change to Chiropractic and Osteopathic Treatments
• Chiropractic treatments: Diagnoses that only describe "pain" is not sufficient to support medical necessity for treatments.
  • The precise level(s) of the subluxation(s) must be specified to substantiate a claim for manipulation of each spinal region(s).
  • The primary diagnosis code must be subluxation, including the level of subluxation, either so stated or identified by a term descriptive of subluxation.
  • Addition of Osteopathic Treatments guidelines

Note: Medicaid Expansion Requirement - Effective June 15, 2026, modifier AT must be appended to all CMT codes (98940–98943) to indicate active/corrective treatment for acute or chronic subluxation. Claims submitted without this modifier will be denied as non-covered.

Questions?  
For additional questions contact the appropriate Provider Service Center:

• Commercial: 800-368-2312
• Medicaid Expansion: 833-777-577