What insurance policy changes affect CPT 98940?

There are 6 tracked policy changes affecting CPT 98940, including updates from Blue Cross and Blue Shield of Kansas City, Blue Cross Blue Shield of North Dakota, Wisconsin ForwardHealth. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 98940?

Payers that have issued tracked updates for CPT 98940 include: Blue Cross and Blue Shield of Kansas City, Blue Cross Blue Shield of North Dakota, Wisconsin ForwardHealth.

How do I get notified when CPT 98940 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 98940. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 98940?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

98940 — A chiropractor treats pain or problems in one or two areas of your body during one visit.: Insurance Policy Changes

98940 Insurance Policy Changes

CPT 98940, in plain terms, covers A chiropractor treats pain or problems in one or two areas of your body during one visit. CPT 98940 is referenced in 6 tracked payer policy changes from Blue Cross and Blue Shield of Kansas City, Blue Cross Blue Shield of North Dakota, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 98940 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

BlueSpeak Provider Newsletter — June 2026

Blue Cross and Blue Shield of Kansas City·Effective Jul 1, 2026

Blue KC issued multiple billing and coding updates effective July 1, 2026, with immediate preparation required. Key changes include: (1) Hemodialysis claims must now include Urea Reduction Ratio (URR) modifiers (G1-G6) on CPT 90999 or face automatic denial; (2) Joint replacement device C1776 is limited to 1 unit for shoulder/knee/hip replacements with stricter medical necessity documentation; (3) Chiropractic billing requires specific diagnosis codes matching each spinal region manipulated; (4) New radiology site-of-care policy may limit hospital-based imaging reimbursement. Additionally, maternity coding changes begin September 1, 2026, requiring E/M code modifications for prenatal visits.

98940 Insurance Policy Changes

BlueSpeak Provider Newsletter — July 2026

BlueSpeak June 2026: Payment Policy Updates

BlueSpeak Provider Newsletter — June 2026

Notice of Processing issue with Chiropractic and Osteopathic Treatment Reimbursement Policy Coding Change

New Chiropractic and Osteopathic Treatments Policy

ForwardHealth Update 2026-12: Prior Authorization Process Improvements: Revising the Prior Authorization/Chiropractic Attachment and Adding a Chiropractic Procedure Code