Specialty billing

Billing built for your specialty

Specialty medical billing works best when the people handling your claims know your field. Every specialty has its own codes, modifiers, and payer rules, so our billers and coders work by specialty and already know what payers look for in yours.

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30+Specialties supported
5Specialty groups
2016Serving practices since

Specialty code explorer

Cardiology codingReviewed
93306Echo, complete, with DopplerCPTChecked
93015Cardiovascular stress testCPTChecked
93458Left heart cath with angiographyCPTChecked
-26Professional component onlyModifierChecked

Example codes. Final coding depends on documentation and payer rules.

Find your specialty

Search or filter to find your specialty

Each specialty has its own page covering the billing problems we solve, example codes, and the services those practices use most.

  • CardiologySpecialty & diagnosticsEcho, stress testing, cath lab, and device monitoring billed with the modifiers payers check.
  • UrologySurgical & proceduralIn-office procedures, lithotripsy, and drug administration billed with the correct units.
  • OrthopedicsSurgical & proceduralSurgical global periods, DME, and multiple-procedure rules handled correctly.
  • Behavioral HealthBehavioral healthTime-based psychotherapy codes, telehealth visits, and authorization tracking.
  • Urgent CarePrimary careHigh-volume E/M visits, on-site testing, and payer-specific rules billed every day.
  • LaboratorySpecialty & diagnosticsPanel coding, medical-necessity checks, and payer-specific lab billing rules.
  • Internal MedicinePrimary careE/M visits, preventive care, chronic care management, and in-office tests.
  • Family PracticePrimary careWell visits, immunizations, and sick visits for patients of every age.
  • GastroenterologySurgical & proceduralColonoscopy screening rules, endoscopy coding, and in-office infusions.
  • RadiologySpecialty & diagnosticsProfessional and technical billing, imaging authorizations, and contrast coding.
  • NeurologySpecialty & diagnosticsEEG, EMG, and nerve conduction studies, plus chemodenervation and infusions.
  • OncologySpecialty & diagnosticsChemotherapy administration, drug units, and prior authorizations.
  • DermatologySpecialty & diagnosticsBiopsies, destructions, Mohs surgery, and cosmetic versus medical billing.
  • OB/GYNSurgical & proceduralGlobal obstetric packages, ultrasounds, and gynecologic procedures.
  • PediatricsPrimary careWell-child visits, vaccines, screenings, and Medicaid billing.
  • TelehealthPrimary carePlace-of-service codes, modifiers, and payer-specific virtual care rules.
  • PsychiatryBehavioral healthE/M with psychotherapy add-ons, medication management, and telepsychiatry.
  • Substance Use TreatmentBehavioral healthAssessments, outpatient and IOP services, including Medicaid H-codes.
  • Physical TherapyTherapy & rehabTimed codes, the 8-minute rule, therapy modifiers, and visit limits.
  • ChiropracticTherapy & rehabSpinal manipulation, active treatment rules, and therapy services.
  • Pain ManagementTherapy & rehabInjections, nerve blocks, radiofrequency ablation, and frequency limits.
  • General SurgerySurgical & proceduralOperative coding, global periods, and assistant surgeon billing.
  • Ambulatory Surgery CentersSurgical & proceduralFacility claims, implants, and discontinued procedure billing for ASCs.
  • Wound CareTherapy & rehabDebridement, skin substitutes, and wound documentation requirements.

We didn't find that one here, but we probably still bill for it. Ask us about your specialty.

Showing 24 of 30+ specialties · Don't see yours?

Why it matters

Generic billing misses specialty details

That's why specialty medical billing matters: most specialty denials come from rules a general biller wouldn't know to check.

Codes and modifiers by specialty

For example, from 26/TC splits in cardiology to timed units in therapy, every specialty has coding rules that change payment.

Payer rules that differ

Payers set different authorization, frequency, and documentation rules by specialty, and we also set them up for yours.

A team that knows your work

Billers and coders who work in your specialty every day handle your claims, not a general queue.

Don't see your specialty?

We bill for more specialties than we can list

Tell us about your practice, and then we'll let you know how we'd handle your billing, including the codes and payer rules specific to your work.

Talk to a billing expert

Get a straight answer about your specialty

Call us Monday to Friday, 8 AM to 5 PM EST, or request a free billing audit and we'll follow up.

Get a Free Billing Audit (505) 472-4627
Client scenarios

Specialty billing in practice

How specialty-specific billing plays out for different kinds of practices.

Client scenarios

Real problems, handled the same way every time

Each example follows the same path: find where revenue is stuck, fix the cause, and keep it fixed.

  • The challenge
  • What we did
  • What changed

These are illustrative examples based on common practice situations, not specific client results.

See what we'd find in yours

  • Cardiology group

    4 providers · in-house billing
    Illustrative scenario
    The challenge
    Echo and stress test claims kept coming back denied for missing authorizations, and professional and technical components were billed inconsistently between the office and the hospital.
    What we did
    Set up authorization checks before imaging visits, corrected 26/TC billing rules by location, and worked the open denials in order of appeal deadline.
    What changed
    Authorization gaps now get caught before the test instead of after the denial, and the front desk knows which visits need attention each morning.
    Cardiology billing

  • Behavioral health practice

    12 clinicians · adding new LPCs
    Illustrative scenario
    The challenge
    Newly hired counselors couldn't bill several payers yet, and some sessions were being billed with time codes that didn't match the documented session length.
    What we did
    Handled payer enrollment and CAQH for the new clinicians, reviewed time-based coding against notes, and began tracking authorizations and session limits.
    What changed
    New clinicians are enrolled and billing, and the team gets a heads-up before a patient reaches a session limit.
    Behavioral health billing

  • Urgent care center

    2 locations · high walk-in volume
    Illustrative scenario
    The challenge
    Claims piled up during busy seasons, and walk-in patients with outdated insurance led to a steady stream of eligibility denials.
    What we did
    Moved to daily claim submission, added same-day eligibility checks for walk-ins, and set up payer-specific rules for global versus itemized billing.
    What changed
    Claims keep going out daily even in peak season, and coverage problems are flagged while the patient is still at the counter.
    Urgent care billing

  • Orthopedic practice

    Switching billing companies
    Illustrative scenario
    The challenge
    The previous vendor left behind a large backlog of claims over 90 days old, and nobody could say how much of it was still collectible.
    What we did
    Ran an A/R cleanup project separate from day-to-day billing, prioritizing claims by value and timely-filing deadline, while onboarding new claims in parallel.
    What changed
    The practice has a clear picture of what's collectible, and old balances are being worked without slowing down current billing.
    Orthopedic billing

  • Family practice

    Solo physician · 1 front-desk staff
    Illustrative scenario
    The challenge
    The physician was catching up on billing at night, and vaccine administration codes were often missed when vaccines were given during sick visits.
    What we did
    Took over the full revenue cycle, set up vaccine product and administration billing together, and started a short monthly review call.
    What changed
    Evenings are no longer spent on claims, and preventive services and vaccines are billed consistently.
    Family practice billing

  • Independent laboratory

    High daily claim volume
    Illustrative scenario
    The challenge
    Tests were denied for medical necessity, and incomplete requisitions left claims stalled for weeks while someone tracked down missing details.
    What we did
    Added diagnosis checks against payer coverage policies, set up requisition follow-up with ordering offices, and monitored clearinghouse rejections daily.
    What changed
    Fewer claims sit waiting for missing information, and rejections are corrected and resent quickly.
    Laboratory billing
FAQ

Specialty billing questions

Something else on your mind? Talk to a billing expert.

We bill and code for more than 30 specialties, including primary care, surgical, diagnostic, behavioral health, and therapy practices. If yours isn't listed, contact us anyway, because there's a good chance we already work with practices like yours.

Yes. Our team works by specialty, so the people handling your claims know your codes, modifiers, and payer rules.

Yes. We bill for groups with several specialties and then set up specialty-specific coding and payer rules for each one.

Yes. We also enroll providers across specialties, including behavioral health clinicians and therapists, whose payer requirements often differ.

See how your specialty's billing stacks up. Start with a free audit.

First, we'll review a sample of your claims. Then we'll show you where specialty rules are costing you revenue.

Get a Free Billing Audit Talk to a Billing Expert