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98%
Family Practice

Comprehensive family medicine billing solutions for all ages.

Specialty highlight

98%

Built around payer rules, documentation requirements, and coding nuances.

E&M Coding Accuracy

98%

Clean Claim Rate

97%

Overview

Billing in Family Practice

A practical view of what makes this specialty unique.

Family practice is the broadest medical specialty, caring for patients of all ages and managing everything from well-baby checks and sports physicals to chronic diseases and acute illnesses. This breadth requires a billing service that is equally versatile. Our family practice billing service is designed to handle this diversity, ensuring accurate coding for every type of encounter—preventive, acute, and chronic—across the entire lifespan, maximizing your revenue and reducing administrative burden so you can focus on comprehensive patient care.

Accurate E&M coding for pediatric, adult, and geriatric patients.

Standardized into our workflow to reduce rework and protect revenue.

Expertise in billing for well-child checks (99381-99385, 99391-99395) and well-adult visits (99386-99397, G0439).

Standardized into our workflow to reduce rework and protect revenue.

Management of coding for in-office procedures (10060, 10120, 12001, 20610, 93000).

Standardized into our workflow to reduce rework and protect revenue.

Coding for vaccine administration (90460, 90471) for all ages.

Standardized into our workflow to reduce rework and protect revenue.

Challenges

What slows reimbursement

The common friction points that trigger delays, denials, and rework.

Key challenges
  • Accurately coding for a wide variety of E&M services across all age groups.
  • Billing for preventive visits (well-child, well-adult) combined with problem-oriented E&M services.
  • Managing the complexities of coding for in-office procedures (suturing, I&D, joint injections, ECGs).
  • Ensuring proper coding for vaccine administration for all ages.
  • Participating in and maximizing revenue from value-based care models and quality programs.
Our solutions
  • Certified family practice coders with broad expertise across all age groups and services.
  • Precise E&M coding based on the latest guidelines, for new and established patients of all ages.
  • Expertise in billing for preventive services (99381-99397, G0438-G0439) and same-day sick visits with modifier 25.
  • Meticulous charge capture for all in-office procedures, labs, and vaccines.
  • Specialized support for Chronic Care Management (CCM) and Transitional Care Management (TCM).
  • Proactive management of quality measures for MIPS and value-based contracts.
Features

Operational features that keep claims clean

Repeatable checks, payer alignment, and tight charge capture.

Accurate E&M coding for pediatric, adult, and geriatric patients.

Included to improve first-pass acceptance and reduce downstream edits.

Expertise in billing for well-child checks (99381-99385, 99391-99395) and well-adult visits (99386-99397, G0439).

Included to improve first-pass acceptance and reduce downstream edits.

Management of coding for in-office procedures (10060, 10120, 12001, 20610, 93000).

Included to improve first-pass acceptance and reduce downstream edits.

Coding for vaccine administration (90460, 90471) for all ages.

Included to improve first-pass acceptance and reduce downstream edits.

Support for CCM (99490), TCM (99495-99496), and AWV (G0439).

Included to improve first-pass acceptance and reduce downstream edits.

Coding

Coding complexities we watch closely

Modifier usage, documentation rules, and specialty-specific payer edits.

Complexity checklist
  • E&M coding based on MDM or time for office visits.
  • Correct use of modifier 25 for significant, separately identifiable E&M on the same day as a preventive visit or procedure.
  • Billing for prolonged services (99415, 99416) when they occur.
  • Coding for preventive visits based on the patient's age.
Denial triggers

Incorrect E&M level selection not supported by documentation.

Missing modifier 25 when billing a procedure or preventive visit with an E&M.

Age-based coding errors for well-child visits.

Incorrect coding of vaccine administration.

Bundling of services that should be reported separately.

Codes

Common codes (examples)

Reference-only examples to illustrate the typical coding landscape.

CPT

99213 (Office Visit), 99395 (Well-Child), 90471 (Vaccine Admin), 93000 (EKG), 20610 (Joint Injection)

ICD-10

J06.9 (URI), I10 (Hypertension), E11.9 (Diabetes), Z00.00 (General Exam), Z23 (Immunization)

FAQ

Frequently Asked Questions

Got questions? We've got answers

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