Chiropractic Services
Compare the average cost insurers paid from April 1, 2022 - March 31, 2023 for chiropractic procedures by county.
How to Use This Report
- Select a healthcare procedure and payor to view the estimated costs by county (available in map and table formats).
- Hover over the map for detailed information, including the county, the number of times commercial insurer(s) paid for the procedure during the reporting period, and the number of chiropractors in each county who billed insurer(s) for the procedure.
Patients may receive multiple types of treatment in a chiropractic appointment. If more than one service is received during the same visit, look up the cost of each service and add them together to get the estimated total cost.
The Steps MHDO Takes to Calculate Chiropractic Procedure Payments on CompareMaine
Step 1: Filter the Data
To create the analytic set, we filter the data by removing claims with missing information, claims from public payors (Medicare and Medicaid), and commercial claims for anyone 65 years old or older, as these claims are often paid for in-part by a public payor like Medicare and including them would distort the average. We do not calculate a payment estimate for a specific procedure if the healthcare setting has fewer than five claims for that procedure in the APCD.
Incomplete Encounters: For procedures that require both professional and facility services, we remove patient encounters that do not include both a professional and facility claim from our estimates.
Encounters Without Payment Data: We remove claims that do not have payment information.
Step 2: Find Claims Linked to a Service or Procedure
We use 13 taxonomy codes from the National Provider Identifier (NPI) Registry to identify chiropractors practicing in Maine and look for the four most common CPT Codes used exclusively by chiropractors:
- Chiropractic treatment, 1+ non-spinal regions (CPT Code 98943)
- Chiropractic treatment, 1-2 spinal regions (CPT Code 98940)
- Chiropractic treatment, 3-4 spinal regions (CPT Code 98941)
- Chiropractic treatment, 5 spinal regions (CPT Code 98942)
Step 3: Calculate the Average Payment
We use the median to calculate the average payment for each of the four chiropractic services listed above by county. We also tally and display the number of providers in each county submitting claims for each service, and the number of times the specific CPT Code appeared in the claims data from April 1, 2022 - March 31, 2023.