Objective Cervical Spine Assessment in Practice: A Workflow Overview from Dr. Ted Arkfeld, DC

Dr. Ted Arkfeld has practiced chiropractic since graduating from Northwestern College of Chiropractic in 1988. His practice serves a mix of insurance (Blue Cross Blue Shield, Medicare) and cash-pay patients in two small towns in Northern Michigan. His patient population includes concussion cases, post-surgical rehab referrals, chronic pain patients, and individuals who have not responded to traditional chiropractic or physical therapy. Dr. Arkfeld has advanced postgraduate training in concussion management and is certified as a professional coder, with a background in training chiropractors in documentation and insurance reimbursement.

Why He Adopted NeckCare

Before NeckCare, Dr. Arkfeld was using J-Tech digital inclinometers for cervical range of motion and the Motion Guidance laser system for joint position error testing. He noted that the Motion Guidance system did not produce numerical output for sensorimotor deficits — it relied on clinical observation rather than quantified data.He began using NeckCare after a demo with a NeckCare sales rep. His primary reason for adopting the system was that it digitized and quantified all three components of cervical assessment — Range of Motion, Joint Position Error, and sensorimotor control in a single platform with objective numerical output. He states this was "the final piece" for his concussion baseline evaluation protocol.

Clinical Workflow

Dr. Arkfeld conducts all three NeckCare assessments himself as part of a broader initial evaluation he calls the "Neurosports Performance Evaluation." This evaluation also incorporates BrainTap, Kinetisense, and Neufit. The NeckCare assessment is administered at

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  Initial evaluation: to establish a baseline across Range of Motion, Joint Position Error (proprioception), and the Butterfly Test (cervicocephalic kinesthetic sensibility / sensorimotor control)

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  Re-examinations: to measure progress against baseline

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  Return-to-activity decisions: particularly for concussion patients being cleared to return to sport or the classroom

He applies this workflow not only to concussion cases but to all patients in his practice, including Medicare patients with fall risk concerns and post-surgical referrals.

Patient Compliance

Dr. Arkfeld states that showing patients their objective deficits, particularly restrictions in range of motion, joint position error, or Butterfly Test scores, and connecting those findings to their functional limitations increases patient compliance with the care plan. In his words: "When we do that initial baseline testing, and they've got issues... they are much more compliant to stay on board."Care plans are structured monthly, with re-evaluation to determine continuation. Visit frequency ranges from 2 to 3 times per week, depending on the patient.

Billing and Reimbursement

Dr. Arkfeld uses NeckCare during billable sessions using the following CPT codes.

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  97112 – Neuromuscular Re-education: He bills 2 units per 30-minute rehab session when patients use NeckCare for guided sensorimotor or proprioceptive exercises. He reports a reimbursement rate of approximately $37 per unit.

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  97110 – Therapeutic Exercise: Applied when patients are taken through active range of motion exercises using NeckCare.

A typical visit with an adjustment and two units of neuromuscular re-education generates over $100. Reimbursement drops as patients improve and need fewer units.Dr. Arkfeld states he has recouped his investment in NeckCare and made so much more. He attributes this to billing NeckCare use under appropriate, medically necessary CPT codes and to the role NeckCare plays in differentiating his practice, which he says increases patient retention and referrals. His practice does not run paid advertising — patient volume is driven entirely by referrals.

Differentiation

Dr. Arkfeld identifies objective assessment data as a key factor in distinguishing his practice from other chiropractors and physical therapists who rely on subjective evaluation methods. He reports frequent patient feedback along the lines of 'never being examined in this way before'. He views this as a driver of both patient trust and long-term retention.

Research Activity

Dr. Arkfeld is currently engaged in an IRB-approved concussion study in collaboration with Neufit. NeckCare is a core measurement device in this study. He has also had an abstract accepted for a national concussion and sports medicine symposium, related to a separate clinical research study involving BrainTap.