Chiropractor Invoice Template
Create professional chiropractor invoices for adjustments, consultations, and therapeutic services. Our template includes fields for insurance codes, NPI numbers, and treatment plan tracking. Perfect for chiropractic clinics and solo practitioners. Download instantly in PDF, Word, or Excel format.
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Subtotal$295.00
Total (USD)$295.00
What to Include on a Chiropractor Invoice
A complete chiropractic invoice should document:
Practice Information- Practice name and address
- Chiropractor name with DC credential
- State license number
- NPI (National Provider Identifier)
- Phone, fax, email
- Tax ID / EIN
- Patient name and DOB
- Address and contact info
- Insurance information
- Account/patient number
- Date(s) of service
- CPT codes for each service
- ICD-10 diagnosis codes
- Description of services
- Units/time for each service
- Fee for each service
- Total charges
- Insurance adjustment (if applicable)
- Patient responsibility
- Copay collected
- Balance due
- Place of service code
- Referring provider (if any)
- Prior authorization number
- Claim/superbill format
Chiropractic Service Pricing Guide
Standard pricing for chiropractic services:
Initial Visit- Consultation only: $50-100
- New patient exam: $100-200
- Comprehensive exam: $150-300
- X-rays (per region): $75-150
- Full spine X-ray: $150-300
- Single region adjustment: $45-75
- Full spine adjustment: $65-120
- Extremity adjustment: $35-55
- Diversified technique: $50-85
- Activator method: $45-75
- Electric stimulation: $25-45
- Ultrasound therapy: $25-45
- Cold laser therapy: $35-75
- Spinal decompression: $75-150
- Therapeutic massage: $40-80
- Kinesio taping: $25-50
- DOT physical: $75-150
- Sports physical: $50-100
- Functional assessment: $100-250
- Nutritional consult: $75-150
- Ergonomic assessment: $100-200
- Monthly maintenance: $150-300/mo
- 10-visit package: 10-15% discount
- Family plans: available
- Cash pay discount: 10-20%
Chiropractic Insurance Billing Basics
Navigate insurance billing effectively:
Common CPT Codes- 99201-99205: New patient E/M
- 99211-99215: Established E/M
- 98940: Spinal CMT (1-2 regions)
- 98941: Spinal CMT (3-4 regions)
- 98942: Spinal CMT (5 regions)
- 98943: Extraspinal CMT
- 97140: Manual therapy
- 97110: Therapeutic exercises
- M54.5: Low back pain
- M54.2: Cervicalgia
- M99.01: Cervical segmental dysfunction
- M99.03: Lumbar segmental dysfunction
- G89.29: Chronic pain
- Proper documentation essential
- Medical necessity required
- Treatment plan on file
- Progress notes per visit
- Re-evaluation as needed
- Verify benefits before first visit
- Know visit limits
- Track authorizations
- Submit claims promptly
- Appeal denials when appropriate
Running a Cash-Based Chiropractic Practice
Many chiropractors operate cash-pay practices:
Advantages- No insurance hassles
- Immediate payment
- Set your own fees
- More time with patients
- Simpler administration
- Competitive single-visit rates
- Package/membership discounts
- Family pricing
- Prepaid care plans
- Monthly wellness memberships
- Provide for out-of-network claims
- Include all required codes
- Patient submits to insurer
- Patient receives reimbursement
- Provider NPI and license
- Patient information
- Date of service
- CPT and ICD-10 codes
- Fees charged
- Provider signature
- Emphasize value and time
- No waiting for approval
- Flexible scheduling
- Personalized care
- Transparent pricing