Allowable Chiropractic Services

June 16, 2022

Dear Provider,

Thank you for your continued partnership with Centene/WellCare Health Plans of New Jersey. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members.

We are writing today to inform providers that there will be a change to the application of the rules governing the provision of Chiropractic Services to Medicaid and NJ FamilyCare beneficiaries. The effective date of this change is August 1, 2022.

In accordance with N.J.A.C. 10:68, the following services will be considered allowable:

98940: chiropractic manipulative treatment; spinal, 1-2 regions
98941: chiropractic manipulative treatment; spinal, 3-4 regions
98942: chiropractic manipulative treatment; spinal, 5 regions
98943: chiropractic manipulation of 1 or more of the extra-spinal regions
99202 through 99205: initial visit E&M codes
97810 through 97814: acupuncture codes

All other services will be disallowed.

We thank you for your commitment to the care and wellbeing of our members and to the communities we serve. Should you have any questions or concerns about this notification, please contact us at Provider Services 1-888-453-2534.

Sincerely,

WellCare Health Plans of New Jersey