Internal medicine billing
Internal medicine billing services
We handle billing for internal medicine practices, from complex office visits to chronic care management, remote patient monitoring and Medicare wellness visits. Claims go out within 24 hours of receiving charges, every denial is worked within 5 business days, and pricing starts at 2.5% of collections.
- Care management billing: CCM, TCM and remote monitoring
- Medicare, Medicare Advantage and secondary claims
- Diagnosis specificity for risk-adjusted plans
Why internal medicine billing is different
Older, sicker patients and a lot of work between visits
Internists care for adults with several chronic conditions, and much of that care happens outside the visit. Getting paid for it depends on time tracking, consent and careful diagnosis coding.
Care between visits
Chronic care management, principal care management and remote patient monitoring pay for monthly work done by the physician and clinical staff. Each has minimum time, consent and care plan rules, and some cannot be billed by two providers in the same month.
Transitional care
After a hospital discharge, TCM codes pay for a contact within 2 business days and a visit within 7 or 14 days, depending on complexity. Missing either window means billing a regular visit instead.
Medicare-heavy payer mix
Many internal medicine patients have Medicare or Medicare Advantage, often with a secondary plan. Claims need to cross over correctly, and Advantage plans may follow their own authorization and coding rules.
Risk adjustment
Medicare Advantage and some commercial plans adjust payment based on documented diagnoses. Diagnosis codes need to be specific and supported by the note each year, such as diabetes with its complications.
Complex E/M and G2211
High-complexity visits (99215) and the G2211 add-on for ongoing care of a serious condition draw payer review. The note has to show the decision making or time that supports the level.
Incident-to and APP billing
NPs and PAs can bill under their own NPI or, when Medicare incident-to rules are met, under the physician. The claim must match who actually saw the patient and whether the plan of care was already set.
Common codes
Internal medicine codes we bill often
| Code(s) | What it is | What we watch for |
|---|---|---|
| 99202–99215 | New and established patient office visits | Level supported by decision making or total time |
| G2211 | Add-on for longitudinal care of a serious or complex condition | Payer acceptance; rules when modifier 25 services are billed the same day |
| 99490 / 99439 / 99487 | Chronic care management, standard and complex | Consent, care plan, monthly minutes and one billing provider per month |
| 99495 / 99496 | Transitional care management | Contact within 2 business days; visit within 14 or 7 days |
| 99453 / 99454 / 99457 / 99458 | Remote patient monitoring setup, device supply and management time | Days of data per period and time spent on interactive communication |
| G0438 / G0439 | Medicare annual wellness visit, initial and subsequent | Once every 12 months; not the same as a routine physical |
| 99497 / 99498 | Advance care planning | Time documented; no cost-share when done with the wellness visit under Medicare |
Codes and rules change. We check current CPT guidance and each payer’s policy before submission.
Common denials we prevent
Internal medicine denials we stop before they happen
Internal medicine denials cluster around care management rules and Medicare coverage. We check them before submission instead of after the denial.
- Care management billed without documented consent or enough minutes
- CCM or RPM also billed by another provider for the same month
- TCM billed when the contact or visit fell outside the required window
- Remote monitoring billed with too few days of readings in the period
- Wellness visit billed before 12 months have passed
- Secondary claims stuck because the Medicare crossover failed
- Unspecified diagnosis codes rejected or underpaid by risk-adjusted plans
What we handle
Everything between the visit and the payment
- Insurance eligibility and benefits checks, including secondary coverage
- Charge entry and coding review of E/M levels, care management and add-on codes
- Claim submission within 24 hours of receiving charges
- Payment posting and ERA reconciliation
- Denial correction, resubmission and appeals within 5 business days
- A/R follow-up on unpaid and underpaid claims
- Commercial, Medicare and Medicaid credentialing for physicians, NPs and PAs
- Patient statements and balance tracking
- Monthly reporting on collections, denials and A/R
Our billing team does not call your patients. Patient calls stay with your practice, or with an optional RevenueCTRL virtual assistant.
Pricing
Clear pricing for internal medicine practices
Billing starts at 2.5% of collections, or a flat monthly fee. There is no setup fee and no long-term contract. Credentialing starts at $80 per payer, and 5 commercial payers are credentialed free when you sign up for billing.
Our core focus is behavioral health. We bill internal medicine and other specialties with the same team, the same CPB-certified billers and the same service promises.
Common questions
Can you bill chronic care management for our practice?
Yes. We bill CCM each month when the patient’s consent, care plan and staff time are documented. We flag patients who did not reach the minimum time so nothing unsupported goes out. Rules vary by payer; we check current policy.
Do you bill remote patient monitoring?
Yes. We bill device setup, monthly device supply and management time, and we check the number of days with readings and the minutes of interactive time before each claim.
How do you handle Medicare secondary claims?
We check secondary coverage at eligibility, confirm whether the claim crosses over automatically, and send it to the secondary payer ourselves when it does not. Stuck secondaries are part of our A/R follow-up.
Do you help with risk-adjustment coding?
We review diagnosis codes for specificity and flag notes that do not support a chronic condition on the claim. We do not add diagnoses the physician did not document.
Can NPs and PAs bill incident-to under the physician?
Under Medicare, only when the incident-to rules are met, such as a plan of care the physician already set and the required physician supervision. Otherwise we bill under the NP or PA’s own NPI. Many commercial payers have their own rules.
How much does internal medicine billing cost?
Billing starts at 2.5% of collections, or a flat monthly fee. There is no setup fee and no long-term contract. We give you an exact quote after a free review of your claims.
Guides from our team
Learn more before you decide
Top 10 Reasons for Medical Claim Denials (And How to Fix Them Fast)
The 10 most common reasons for medical claim denials, what each one costs your practice, and the exact fix for each. Plus a denial-prevention checklist.
Read the guide →Claim Denial Codes Explained: What CO-16, CO-50, CO-197, PR-1 and Others Mean and How to Fix Them
What common denial codes mean (CO-16, CO-18, CO-50, CO-97, CO-197, PR-1 and more) and how to fix each, for mental health and medical practices.
Read the guide →Medical Billing Services for Small Practices: Complete Guide to Maximizing Revenue
Explore medical billing services for small practices, from claim submission and payment posting to denial follow-up, with practical steps to improve revenue.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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