High-performing billing partners provide full-service billing for primary care, family medicine, and internal medicine practices — accurate E&M coding, Annual Wellness Visit billing, Chronic Care Management, and complete AR management. Most primary care practices are leaving 15–25% of Medicare revenue unbilled through missed AWV and CCM codes alone.
Primary care billing requires mastery of E&M documentation under the 2021 AMA guidelines, plus specialized knowledge of Medicare-only codes that most generalist billers miss entirely — Annual Wellness Visits (G0438/G0439), Chronic Care Management (99490/99491), Transitional Care Management (99495/99496), and Advance Care Planning (99497). A typical 3-physician primary care practice billing these codes correctly adds $8,000–$15,000 per month in legitimate Medicare revenue that they were previously leaving unbilled.
Medicare-covered preventive visit. Distinct from E&M. Can be billed same day as E&M with modifier -25. Fewer than 40% of eligible visits are billed with G0438/G0439 — most are incorrectly billed as office visits.
For Medicare patients with 2+ chronic conditions. 20 minutes of care management per calendar month. Fewer than 20% of eligible primary care practices bill CCM — the remaining 80% leave an average of $10,000+/month unbilled.
Post-hospital discharge follow-up within 14 days (99495) or 7 days (99496). Requires contact attempt within 2 business days of discharge. Significantly higher RVU value than a standard office visit for the same time.
Billable for face-to-face discussions of advance directives. Can be billed same day as E&M or AWV. Waived Medicare cost-sharing when billed with AWV. Rarely billed despite being widely performed.
Post-2021 E&M revision, MDM complexity now drives code selection. Many practices default to 99213 out of habit when the documented MDM clearly supports 99214. Audit of 100 charts typically finds 30–40% undercoded.
2021 AMA E&M guidelines applied correctly — MDM-based and time-based coding. Regular E&M audits to identify undercoding patterns without creating overcoding risk.
AWV (G0438/G0439), IPPE (G0402), depression screening (G0444), alcohol screening (G0442), and all Medicare preventive service codes billed correctly and completely.
Chronic Care Management (99490/99491), Remote Patient Monitoring (99453/99454/99457), and Principal Care Management (99424/99425) — the fastest-growing revenue opportunity in primary care.
Complex same-day billing rules — AWV + E&M, preventive + problem-focused, multiple problems in one visit — applied correctly to maximize revenue without triggering payer edits.
In-office procedure billing — EKG, spirometry, wound care, skin procedures — plus lab service billing under the CLIA waiver or PPM certificate your practice holds.
High-volume primary care patient billing with automated statements, payment plan setup, and professional collections for deductible and copay balances.
A free billing audit identifies your missed AWV, CCM, and E&M coding opportunities — and calculates exactly how much additional revenue is available from work you're already doing.