Specialty billing

Medical Billing by Specialty

Coding rules, modifier logic and denial patterns change from one specialty to the next. We bill across 25 of them, with staff who know the difference.

Get a proposal (805) 979-7829

Years in revenue cycle

48h

Claim filing window

30d

Target days to payment

HIPAA

Compliant by design

25 specialties

Choose your specialty

Ambulance Transportation billing

Ambulance claims live or die on paperwork written in the back of a moving vehicle. Every run needs a level of service, a loaded mileage figure, a two-character origin and destination modifier, and a run report that shows why other transport was unsafe.

Anesthesia billing

Anesthesia is the one specialty where the fee is calculated rather than looked up. Payment comes from base units tied to the surgical procedure, plus time units drawn from the anesthesia record, plus qualifying circumstances, all multiplied by a conversion factor.

Cardiology billing

Cardiology bills three different businesses at once. There is office evaluation and management, a diagnostic arm with global, professional and technical splits, and an interventional arm where a single cath lab session can generate a dozen codes governed by bundling edits.

Chiropractic billing

Chiropractic reimbursement turns on one distinction that payers police aggressively: active treatment versus maintenance care. Manipulation codes are simple to select, but the region count, the AT modifier, and the treatment plan showing measurable functional improvement decide whether a visit is paid or written off after the fact..

Dental billing

Dental claims run on their own code set, their own claim form, and benefit structures built around annual maximums and frequency limits rather than medical necessity. Add attachments, waiting periods, and the constant question of whether a procedure should bill to dental or medical, and the administrative load per dollar collected is high..

Dermatology billing

Dermatology coding is a counting exercise performed under a microscope. Payment depends on lesion type, lesion count, excised diameter including margins, closure complexity, and whether the same visit also supported a separate evaluation.

Durable Medical Equipment (DME) billing

DME is a documentation business that happens to ship products. The claim itself is short.

Emergency Medicine billing

Emergency departments generate high claim volume with the least control over payer mix and the least opportunity to verify anything up front. Coding depends on acuity documented under time pressure, procedures performed during resuscitation are frequently never charged, and a meaningful share of encounters arrive with no usable insurance information at all..

Family Practice billing

Family practice earns thin margins on high volume, which makes small billing errors expensive at scale. The recurring problems are structural: preventive visits that also address chronic problems, wellness visits confused with physicals, immunization administration billed incompletely, and care management services delivered but never reported..

General Surgery billing

Surgical revenue is decided by the operative note and the global period that follows it. Multiple procedures in one session trigger payment reductions, unrelated care during the global window needs the right modifier to be paid at all, and assistant surgeon claims depend on payer rules that vary by procedure code..

Hospital billing

Hospital revenue cycles fail at the seams. Status determination between inpatient and observation changes payment fundamentally, coding depends on documentation from physicians who do not see the financial consequence, and transfers, readmissions and payer status changes create disputes that surface long after the patient has gone home..

Internal Medicine billing

Internists manage patients with several active conditions at once, and the billing rarely reflects it. Visits get leveled on habit rather than on documented decision making, transitional care after a hospital discharge goes unbilled, and chronic conditions that drive risk adjustment are treated during the visit but never coded on the claim..

Mental Health billing

Behavioral health billing is governed by the clock and by session limits. Psychotherapy codes are selected by documented face-to-face time, add-on codes attach to medical evaluation services in a specific order, and many plans still route behavioral benefits to a separate administrator with its own network and authorization rules..

OB/GYN billing

Obstetric billing works differently from every other specialty because most of the care is bundled into one global package billed after delivery. Visits accumulate for months with no cash flow, patients change plans mid-pregnancy, and the moment care is split between practices the global package has to be unwound into individual components..

Oncology billing

Oncology carries the highest dollar value per claim and the least tolerance for error. Drug acquisition costs are paid before the claim is submitted, so a units mistake or a missing authorization is not a delayed payment, it is a direct loss.

Optometry billing

Optometry is the specialty where the same patient can be billed to two entirely different plans depending on why they came in. Routine vision benefits and medical coverage have separate networks, separate fee structures and separate rules, and the decision about which one applies is made by the chief complaint rather than by the findings..

Orthopedic billing

Orthopedic practices run a clinic, an imaging suite, a procedure room and an operating room schedule, each with its own billing rules. Fracture care carries a global period that starts in the office, injections and imaging performed the same day face bundling edits, and a large share of the volume arrives through workers compensation with entirely separate requirements..

Pain Management billing

Interventional pain procedures are among the most tightly controlled services in medicine. Payers publish policies specifying how many levels may be treated in a session, how many sessions per year, what conservative care must precede them, and what pain relief must be documented before a diagnostic block can progress to ablation..

Pediatrics billing

Pediatric practices see high volume at modest reimbursement, with a payer mix that leans heavily on Medicaid and CHIP. Revenue depends on capturing everything a well-child visit contains: age-appropriate preventive codes, each vaccine component administered, developmental and behavioral screenings, and any sick complaint addressed at the same appointment..

Physical Therapy billing

Physical therapy billing is arithmetic performed on treatment minutes. Timed codes convert to units under a specific counting rule, untimed codes pay once per session regardless of duration, and certain code pairs need a distinct service modifier to survive edits.

Podiatry billing

Podiatry has a coverage problem no other specialty shares: routine foot care is excluded by default. Nail and callus care becomes payable only when a qualifying systemic condition is present, documented with specific class findings, and reported with the correct Q modifier.

Radiology billing

Radiology revenue depends on getting the component split right on every claim. The same study can be billed globally, professionally, or technically, and which applies depends on who owns the equipment and where the read happened.

Skilled Nursing Facility billing

Skilled nursing billing depends on eligibility conditions established before the resident arrives and on assessments completed after admission. A qualifying hospital stay, available benefit days, an accurate MDS, and consolidated billing rules that make the facility responsible for services it did not order all shape whether a stay is paid correctly..

Urology billing

Urology mixes office visits with a heavy schedule of in-office procedures, imaging, laboratory work and surgery. Cystoscopy alone spans a large code family where the base procedure and its variants are mutually exclusive, and many office procedures include supplies and imaging that practices either double-bill or forget entirely..

Wound Care billing

Wound care coding turns on two measurements and one distinction. Surface area determines units, depth of tissue removed determines which debridement family applies, and the difference between selective and surgical debridement changes payment substantially.

Specialty billing

The rules change. So does the way we bill.

Anesthesia units, radiology component splits, therapy time thresholds, obstetric global packages — each specialty is worked by staff who know its coding reality.

25Specialties billed

48 hoursCharge to payer

Glass medical cross surrounded by a shield, clinic, insurance card, record and calendar

Next step

Ready to see what your revenue cycle is leaving behind?

Send us your specialty, claim volume and current billing setup. We will come back with a proposal you can act on.

Get a proposal Call (805) 979-7829