Chiropractor Invoice Template
A chiropractor invoice bills visit, lists services and products on separate lines and states the terms (Due at each visit; prepaid care plans paid at the start). This template is pre-filled for a new patient with low back pain: exam, lumbar X-rays, six adjustments and two kinds of therapy: 7 lines totalling $674.00 before tax. Edit it and download the PDF.
Pre-filled for a chiropractor: a new patient with low back pain: exam, lumbar x-rays, six adjustments and two kinds of therapy. Example prices: replace them with your own.
From
Granite Chiropractic
525 Market Street
Salem, MA 01970
billing@example.com
(512) 555-0125
Invoice
Bill to
Dana Whitfield
14 Elm Street
Franklin, TN 37064
client@example.com
| Description | Qty | Rate | Amount |
|---|---|---|---|
| New patient exam and consultation | 1 visit | $95.00 | $95.00 |
| Lumbar X-rays, two views | 1 each | $85.00 | $85.00 |
| Spinal adjustment, 1-2 regions (CPT 98940)Lumbar and pelvic | 6 visit | $55.00 | $330.00 |
| Electrical muscle stimulation, unattended | 3 visit | $20.00 | $60.00 |
| Therapeutic ultrasound (CPT 97035) | 2 15 min | $25.00 | $50.00 |
| Lumbar support belt | 1 each | $39.00 | $39.00 |
| Reusable cold therapy pack | 1 each | $15.00 | $15.00 |
- Subtotal
- $674.00
- Balance due
- $674.00
Notes
Thank you for choosing Granite Chiropractic. Terms: Due at each visit; prepaid care plans paid at the start.
Payment details
Bank transfer or card. Please quote the invoice number.
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Chiropractor invoice at a glance
| Typical job | A new patient with low back pain: exam, lumbar X-rays, six adjustments and two kinds of therapy |
|---|---|
| Main billing unit | visit |
| Usual payment terms | Due at each visit; prepaid care plans paid at the start |
| Deposit practice | Prepaid care plans are paid in full or in installments before the series of visits begins, usually at a discount to the single-visit price. |
| Sample lines | 7 lines, $674.00 before tax |
| Largest line | Spinal adjustment, 1-2 regions (CPT 98940): $330.00 (49%) |
| Trade-specific fields | Chiropractic license no. (DC), NPI, Spinal regions treated, Diagnosis code (ICD-10), Care plan and visit count, Date of accident (auto or work injury) |
Sample chiropractor invoice line items
A new patient with low back pain: exam, lumbar X-rays, six adjustments and two kinds of therapy: 7 lines adding up to $674.00, split into services $620.00 (92%) and products $54.00 (8%).
| Item | Qty | Rate | Amount |
|---|---|---|---|
| New patient exam and consultation | 1 visit | $95.00 | $95.00 |
| Lumbar X-rays, two views | 1 each | $85.00 | $85.00 |
| Spinal adjustment, 1-2 regions (CPT 98940) (Lumbar and pelvic) | 6 visit | $55.00 | $330.00 |
| Electrical muscle stimulation, unattended | 3 visit | $20.00 | $60.00 |
| Therapeutic ultrasound (CPT 97035) | 2 15 min | $25.00 | $50.00 |
| Lumbar support belt | 1 each | $39.00 | $39.00 |
| Reusable cold therapy pack | 1 each | $15.00 | $15.00 |
| Subtotal | $674.00 | ||
| Total before tax | $674.00 |
What a chiropractor invoice should include
- Your chiropractic practice name, address, phone and email, plus a tax ID if you are registered
- The customer's name and billing address (Dana Whitfield in the sample)
- A unique invoice number (INV-4771) and the issue date
- Payment terms and a due date: Due at each visit; prepaid care plans paid at the start
- Chiropractic license no. (DC): for example LIC-621076
- NPI: for example See notes
- Spinal regions treated: for example See notes
- Diagnosis code (ICD-10): for example See notes
- Line items in visit or per item, each with quantity, rate and amount
- How to pay you: bank details, card link or cheque payee
How chiropractors bill
Charges per adjustment visit, with a higher new-patient exam fee, X-rays and therapies priced separately and prepaid care plans sold at a per-visit discount.
Chiropractors commonly use "Due at each visit; prepaid care plans paid at the start". Prepaid care plans are paid in full or in installments before the series of visits begins, usually at a discount to the single-visit price.
U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2024: median hourly wage of Chiropractors $37.98 (employees, not contractor rates).
Chiropractor invoicing tips
- Code adjustments by the number of spinal regions treated (98940 for one or two, 98941 for three or four, 98942 for five) and name the regions on the line, so the invoice itself supports the code.
- A prepaid care plan invoice should show the total paid, the visits used and the value per visit, because a patient who stops halfway will ask what the unused visits are worth.
- For auto-accident or workers' compensation cases, put the claim number, the adjuster and the date of injury in the header, and bill that payer separately from the patient's own visits.
- Charge X-rays as their own line with the views taken, since patients who arrive with recent imaging from elsewhere expect that line to disappear.
Chiropractor billing disputes to head off
- Insurers that cover only active treatment often refuse maintenance visits, and patients then dispute the balance. Marking each visit as active care or maintenance on the invoice sets expectations early.
- Selling a prepaid plan and then also billing insurance for the same visits double-counts payments; the invoice should show which payer each visit is charged to.
Work a chiropractor can bill for
Core tasks of Chiropractors (O*NET 29-1011.00, O*NET 29.x task statements, CC BY 4.0). Each can become a line on the invoice.
- Perform a series of manual adjustments to the spine or other articulations of the body to correct the musculoskeletal system.
- Evaluate the functioning of the neuromuscularskeletal system and the spine using systems of chiropractic diagnosis.
- Diagnose health problems by reviewing patients' health and medical histories, questioning, observing, and examining patients and interpreting x-rays.
- Maintain accurate case histories of patients.
- Advise patients about recommended courses of treatment.
- Obtain and record patients' medical histories.
How to make a chiropractor invoice
-
Add both parties
Enter Granite Chiropractic (your business) and the customer, Dana Whitfield, then chiropractic license no. (dc).
-
Number and terms
Give it a unique number such as INV-4771 and set the terms to Due at each visit; prepaid care plans paid at the start.
-
List the work
One line per item: the sample runs from "New patient exam and consultation" (1 visit) to "Reusable cold therapy pack" (1 each).
-
Check the total
The 7 lines come to $674.00; add sales tax only if your state taxes chiropractic care.
-
Download and send
Download the PDF or print it, then keep a copy with the chiropractic care records.
Frequently asked questions
How do I make a chiropractor invoice?
Add your chiropractic practice details, the customer, chiropractic license no. (dc), npi, spinal regions treated and diagnosis code (icd-10), then one line per item with quantity and rate. The template above is pre-filled with 7 lines for a new patient with low back pain: exam, lumbar X-rays, six adjustments and two kinds of therapy totalling $674.00; change the prices and download the PDF.
How do chiropractors charge?
Mostly visit. Charges per adjustment visit, with a higher new-patient exam fee, X-rays and therapies priced separately and prepaid care plans sold at a per-visit discount.
When should a chiropractor invoice be paid?
Due at each visit; prepaid care plans paid at the start is the usual arrangement. Prepaid care plans are paid in full or in installments before the series of visits begins, usually at a discount to the single-visit price. Put the terms and the due date on the invoice so there is no doubt.
How much do chiropractors earn per hour?
U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2024: median hourly wage of Chiropractors $37.98 (employees, not contractor rates). Self-employed rates are usually higher because they cover overhead and unbilled time.