Eligibility & Verification
Coverage checks before every visit.
Specialty Billing
Family Medicine Medical Billing
Family medicine practices juggle preventive visits, acute care, and chronic disease management — often in a single day. We keep your high-volume billing accurate so every E/M level, wellness visit, and chronic care service is captured and paid.
The Challenge
Family Medicine billing, solved
We understand the billing complexities unique to family medicine and build them into every claim.
- High claim volume with varied E/M levels
- Preventive vs. problem-oriented visit coding
- Chronic care and wellness visit billing
What we focus on
- E/M coding (99202–99215)
- Annual wellness & preventive visits
- Chronic Care Management (CCM)
Coding Focus
Family Medicine code sets we work in
The CPT/HCPCS procedure families and ICD-10 diagnosis groups our certified coders handle for this specialty every day.
Common CPT / procedure codes
- 99202–99215Office visits for new and established patients
- 99381–99397Age-based preventive and periodic wellness exams
- G0438–G0439Medicare initial and subsequent wellness visits
- 99490–99491Monthly chronic care management coordination services
ICD-10 diagnosis focus
- Z00–Z13 encounters for general exams and preventive screening
- E11 diabetes and E78 lipid disorders for ongoing chronic management
- I10 essential hypertension and related cardiovascular risk factors
- Z79 long-term medication therapy and monitoring status
Code references are shown as general identifiers for illustration. Actual code selection always follows current payer rules and your provider's documentation.
Clean Claims
Modifiers, denials & billing rules we manage
How our team keeps family medicine claims compliant — the modifiers that matter, the denials we prevent, and the guidelines we follow.
Key modifiers
- 25
Appended when a problem-focused visit is medically necessary and documented alongside a same-day preventive exam or minor procedure.
- 33
Flags ACA-covered preventive and screening services so the patient owes no cost sharing.
- 95
Identifies E/M encounters delivered through real-time audio-video telehealth in primary care.
- 59
Marks a distinct injection or procedure that would otherwise be bundled into the visit.
Common denials & fixes
Preventive and problem visit billed together are denied as bundled.
Document the two services separately and append modifier 25 to the problem-oriented E/M.
Chronic care management time or consent cannot be substantiated.
Track and log the qualifying monthly minutes and record documented patient consent before claiming.
Annual wellness visit rejected for exceeding frequency limits.
Verify eligibility and confirm at least twelve months since the last covered wellness visit.
Screening or preventive service denied for a missing or invalid diagnosis.
Link the correct Z-code and any risk-factor diagnoses that support the encounter.
Billing guidelines
- Select E/M levels using documented total time or medical decision making under current outpatient rules.
- Keep preventive and problem-oriented work in distinct note sections when both occur on one date.
- Confirm Medicare wellness-visit eligibility and twelve-month spacing before scheduling the encounter.
- Record monthly care-coordination minutes and consent to support recurring chronic care management billing.
End-to-End
What we handle for Family Medicine
A complete revenue cycle service tailored to your specialty.
Specialty Coding
Certified, specialty-trained coders.
Charge Entry & Claims
Clean, accurate claim submission.
Payment Posting
ERA/EOB posting and reconciliation.
Denial & AR Management
Appeals and aggressive AR recovery.
Reporting & Analytics
Real-time KPIs and insights.
98%
Clean claim rate
30%
Average revenue lift
24/7
Operations coverage
HIPAA
Compliant processes
FAQ
Family Medicine billing — FAQs
Yes — our certified coders are trained on specialty-specific rules, code sets, and payer policies, and we assign coders with experience in your specialty.
We work in your current practice management system and EHR, so your workflows and reporting stay intact while we handle the billing.
Through accurate specialty coding, front-end eligibility checks, clean claim submission, and relentless denial and AR follow-up — typically lifting first-pass acceptance and net collections.
Always. We use strict access controls, encryption, signed BAAs, and audit trails to protect patient data.
More Specialties
Other specialties we bill for
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