Medical billing guides for practices and billing teams
Practical, specialty-specific billing guides for medical billing companies, physician practices, and behavioral health organizations. Each guide covers CPT code families, documentation, telehealth rules, prior authorization, and common denials.
These guides are for general operational reference only and are not legal or coding advice. Always verify each payer's policy, your provider contracts, and the current AMA CPT manual before submitting claims.
Sleep Medicine Billing Guide
Sleep medicine billing across E/M visits, home sleep apnea testing (95800, 95801, 95806, G0398-G0400), attended polysomnography (95807-95811, 95782/95783), split-night studies, MSLT and MWT, professional and technical components, prior authorization, Medicare PAP coverage and the day 31 to day 91 compliance window, oral appliance coordination, telehealth, denial prevention, and AR.
Read the sleep medicine billing guideWound Care Billing Guide
Wound care billing across diagnosis specificity, debridement by tissue depth and area (97597/97598, 97602, 11042-11047), E/M and modifier 25, NPWT, compression and casting, cellular and tissue-based products, the 2026 Medicare skin substitute payment change, hyperbaric oxygen therapy, NCCI edits, denial prevention, and AR.
Read the wound care billing guideHome Health Billing Guide
Medicare home health billing under PDGM: eligibility and homebound status, the 60-day certification and 30-day payment periods, Notice of Admission timing and TOB 032A, OASIS, PDGM clinical groups, HIPPS and revenue code 0023, LUPA management, partial period payments, claim types, denial prevention, AR follow-up, and 2026 updates.
Read the home health billing guideBehavioral Health Integration Billing Guide
General BHI and Psychiatric CoCM billing across 99484, 99492-99494, G2214, and G0323: initiating visits, documented consent, the behavioral health care plan, registry and measurement-based care, monthly time capture, same-month overlap controls, the 2026 APCM add-ons and RHC/FQHC transition, and denial prevention.
Read the BHI billing guidePhysical Therapy Billing Guide
Outpatient PT billing across evaluation codes 97161-97164, timed treatment codes and the Medicare 8-minute rule, GP/KX/CQ and modifier 59, plan-of-care certification, diagnosis and medical necessity, NCCI edits, denial prevention, payment posting, and billing KPIs.
Read the physical therapy billing guideNeurology Billing Guide
Neurology billing across E/M and G2211, EEG (routine, long-term, technical/professional components), EMG and nerve conduction studies, botulinum toxin and drug units, infusions, lumbar puncture, neuropsychological testing, prior authorization, modifiers, and denial prevention.
Read the neurology billing guideRemote Patient Monitoring Billing Guide
RPM CPT codes 99453, 99454, 99457, 99458, and the 2026 additions 99445 and 99470: medical necessity, consent, device and data transmission requirements, time tracking, example scenarios, and the billing mistakes that cause denials.
Read the RPM billing guideSpravato Billing Guide
Esketamine (Spravato) billing for psychiatry and behavioral health: J0013, G2082/G2083, units and NDC reporting, REMS and 2-hour monitoring documentation, prior authorization, buy-and-bill vs. specialty pharmacy scenarios, and denial prevention.
Read the Spravato billing guideABA Billing Guide
Applied Behavior Analysis CPT codes, prior authorization, unit calculation, session documentation, modifiers, place of service, same-day services, clean claim checks, and denial prevention for ABA and autism service providers.
Read the ABA billing guidePsychiatry Billing Guide
Psychiatric diagnostic evaluations, E/M and medication management, psychotherapy add-on codes, telepsychiatry, Spravato/esketamine, TMS, collaborative care, documentation, and denial prevention for psychiatry practices.
Read the psychiatry billing guidePsychology Billing Guide
Psychotherapy CPT codes, psychological and neuropsychological testing, telehealth modifiers, documentation checklists, prior authorization, and common denials for psychology and behavioral health practices.
Read the psychology billing guideReady to Build Your Billing Team?
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