Code of Massachusetts Regulations
233 CMR - BOARD OF REGISTRATION OF CHIROPRACTORS
Title 233 CMR 4.00 - Standards of Practice and Professional Conduct
Section 4.09 - Improper Charges

Universal Citation: 233 MA Code of Regs 233.4

Current through Register 1531, September 27, 2024

(1) Improper charges shall constitute a form of "deceit" and "gross misconduct in the practice of the profession", within the meaning of M.G.L. c. 112, § 61, and a form of "unprofessional conduct" within the meaning of M.G.L. c. 112, § 93.

(2) Charges for all services provided by a chiropractor shall be based on currently accepted and clinically appropriate procedure codes, including but not limited to Current Procedural Terminology (CPT) codes, or equivalent codes, and the relative value units ascribed to such codes.

(3) Without limiting the definition of improper charges, the following charges shall be considered improper charges:

(a) Charges for overutilization of practice, as defined in 233 CMR 4.08;

(b) Charges for adjustment/manipulation which are not based on currently accepted procedure codes;

(c) Charges which are based on a level of coding which is not consistent with the patient's clinical history, the subjective and objective clinical findings concerning the patient which were made at the time of the visit, the complexity of the clinical decision-making involved in the diagnosis and/or treatment of the patient, or the nature of the care provided to that patient;

(d) Charges for treatments, procedures or services which were not rendered, were not fully rendered, or were not rendered as represented by the charging chiropractor;

(e) Charges for any treatment, procedure or service which is provided to a patient on a particular office visit occurring on a particular day, if the charging chiropractor has advertised or proposed that any of his or her professional services will be provided free on that same day; or

(f) Charges billed to any third party payor for any service advertised as "free".

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