Geriatrics Medical Billing Services
Med Bridge handles geriatrics medical billing for geriatricians, senior care practices, and long-term care providers accurate CPT/ICD-10 coding, Medicare coordination, and denial recovery. Get a free billing analysis.
Geriatrics billing looks simple until you're in it. Most patients are on Medicare, many have secondary coverage, and a lot of them are in facilities rather than the office. Annual wellness visits have their own coding rules. Chronic care management needs documented time. Advance care planning has its own code. And when a patient moves between the office, the nursing home, and the hospital, the place of service changes everything about how the claim gets paid. Med Bridge takes the whole geriatrics revenue cycle off your plate, from eligibility checks through denial appeals, so you get paid for the care you provide.
15+ years in medical billing
110+ geriatrics and senior care providers served
HIPAA Compliant
Geriatrics Medical Billing Services
Med Bridge LLC
Geriatrics Medical Billing Services Specifications
Complete field-by-field overview for geriatrics practices
| Service Type | Geriatrics Medical Billing & Revenue Cycle Management |
|---|---|
| Practices Served | Independent geriatricians, geriatrics group practices, senior care clinics, house call practices, nursing home attending physicians, assisted living providers, PACE programs, geriatric psychiatry practices, multi-specialty groups with geriatrics focus |
| Services Covered | Office E/M visits, Medicare annual wellness visits (AWV), chronic care management (CCM), advance care planning, transitional care management (TCM), nursing home visits, house calls, dementia and cognitive assessments, fall risk evaluations, polypharmacy reviews, immunizations, telehealth visits |
| Coding Systems | CPT, ICD-10, HCPCS with expertise in AWV codes (G0438–G0439), CCM codes (99490, 99491, 99487), TCM codes (99495–99496), advance care planning (99497–99498), nursing home E/M codes (99304–99318), and modifier 25, 59 usage |
| Pricing | Percentage of collections no hidden fees, no setup charges |
| EHR/PMS Compatibility | Epic, Cerner, eClinicalWorks, athenahealth, NextGen, Allscripts, DrChrono, Practice Fusion |
| Compliance | HIPAA-compliant, SOC 2 Type II certified |
97.9%
Clean Claim Rate
24
Days Avg. A/R
4.0%
Denial Rate
48-hour
Claim Turnaround
What Is Geriatrics Medical Billing?
Geriatric medical billing services cover the full revenue cycle for senior care practices: eligibility verification, charge capture, CPT/ICD-10/HCPCS coding, claim submission, payment posting, and denial management. But geriatrics billing isn’t general medicine billing with older patients. The Medicare coordination and care management rules are their own world.
Medicare Annual Wellness Visit Billing & Coding
The annual wellness visit (G0438 for initial, G0439 for subsequent) has its own documentation requirements health risk assessment, cognitive assessment, functional status, and a written screening schedule. Bill it as a regular E/M and the claim gets denied.
Chronic Care Management Billing & Time Tracking
CCM codes (99490, 99491, 99487) pay for the coordination work that happens between visits. That means documented time, a care plan, and patient consent. Without the time log and care plan, the claim doesn't hold up.
Transitional Care Management Billing
TCM codes (99495–99496) pay for managing a patient after discharge from a hospital or nursing facility. There are specific time windows for the face-to-face visit and the interactive contact, and both have to be documented. Miss the window, and the claim gets denied.
Advance Care Planning Billing & Coding
Advance care planning (99497–99498) has its own code and documentation requirements who was present, what was discussed, and how long it took. It can be billed on the same day as an AWV or E/M with the right modifier.
Nursing Home & Facility Visit Billing
Nursing home E/M codes (99304–99318) bill differently from office visits, and the place of service has to match where the patient was actually seen. Billing a nursing home visit under POS 11 is a common and costly error.
House Call Medical Billing & Coding
House call codes (99341–99350) have their own documentation requirements and travel-related rules. The place of service matters, and so does the time spent.
Chronic Condition & Polypharmacy Billing
Geriatric patients usually have multiple chronic conditions, and the E/M level depends on how many are addressed and how complex the management is. You and Undercode lose revenue. Overcode and you're looking at an audit.
Geriatrics Coding & Payer Rule Updates
We stay current with geriatrics coding and payer updates, keeping E/M levels, chronic care services, preventive visits, and care management claims aligned with current billing rules and documentation requirements.
Denial Management & Appeals
Denials get worked within 24–48 hours. Appeals go out with clinical documentation, coding rationale, and regulatory citations. We track why denials happen so we can fix the root cause upstream.
Our Geriatrics Medical Billing & Revenue Cycle Management Process
Every claim goes through a five-step process built to stop denials before they happen, not chase them after.
Eligibility & Insurance Verification
We check Medicare, Medicare Advantage, Medicaid, and secondary coverage before the patient arrives. Coordination of benefits gets verified so claims go to the right payer first.
Charge Capture
Every service office visits, AWVs, CCM time, TCM, advance care planning, nursing home visits, house calls gets turned into billable line items with correct place of service and time documentation.
Geriatrics-Specific Medical Coding
Certified coders apply CPT, ICD-10, and HCPCS codes carefully: AWV documentation, CCM time and care plans, TCM windows, advance care planning, and nursing home E/M codes matched to POS. Every code supports the documentation.
Claim Scrubbing & Submission
Before anything leaves the system, we catch AWV coding errors, CCM time gaps, TCM window misses, POS mismatches, modifier 25 problems, and NCCI edits. Clean claims go out within 24 hours.
Payment Posting
ERA/EOB posting is matched against expected reimbursement. Underpayments on care management claims are identified, reviewed, and appealed—not written off.
Denial Management & Appeals
Denials get worked within 24–48 hours. Appeals go out with operative notes, coding rationale, and regulatory citations. We track why denials happen so we can fix the root cause upstream.
Eligibility Verification
We check Medicare, Medicare Advantage, Medicaid, and secondary coverage before the patient arrives. Coordination of benefits gets verified so claims go to the right payer first.
Geriatrics-Specific Medical Coding
Certified coders apply CPT, ICD-10, HCPCS codes carefully: AWV documentation, CCM time and care plans, TCM windows, advance care planning, and nursing home E/M codes matched to POS.
Payment Posting
ERA/EOB posting is matched against expected reimbursement. Underpayments on care management claims are identified, reviewed, and appealed—not written off
Charge Capture
Every service office visits, AWVs, CCM time, TCM, advance care planning, nursing home visits, house calls gets turned into billable line items with correct place of service and time documentation.
Claim Scrubbing & Submission
Before anything leaves the system, we catch AWV coding errors, CCM time gaps, TCM window misses, POS mismatches, modifier 25 problems, and NCCI edits. Clean claims go out within 24 hours.
Geriatrics Prior Authorization & Billing Compliance
Prior authorization matters for skin substitutes and NPWT, where a single application can run into thousands of dollars. We treat it as a core part of the job, not a side task.
Services that commonly require prior auth:
Skin substitutes and grafts
Negative pressure wound therapy
Advanced wound care products
Extended debridement courses
Some compression therapy
How we handle it:
Real-time eligibility and authorization tracking we know which payers require auth, which don't, and which have their own clinical criteria
Prior auth requests submitted with documentation that meets payer criteria the first time
Product selection guidance so the right skin substitute is used for the payer's coverage rules
Follow-up on pending authorizations so treatment doesn't get delayed
Compliance with the CMS Interoperability and Prior Authorization final rule for turnaround times
Compliance monitoring:
HIPAA-compliant workflows and data security
Documentation audits to keep debridement measurements, skin substitute coding, and modifier 25 defensible
Payer-specific rule tracking for skin substitutes, NPWT, and debridement frequency
Annual coder training on CPT updates and wound care coding changes
Real Numbers From Geriatrics Medical Billing Services
These numbers come from our active geriatrics clients. We don't publish wishful benchmarks we publish results.
0
Days
Average Days in A/R
0
Hours
Claim Turnaround Time
0
%
Clean Claims Rate
15- 0
%
Average Collections Increase
0
%
Denial Rates
0
%
Prior Authorization Approval
0
%
Payment posting accuracy
0
%
First-pass acceptance rate
Geriatrics Medical Billing & Specialty Coding Services
General billing companies treat geriatrics like any other primary care practice. We treat each service family as its own workflow with its own rules.
Annual Wellness Visit Billing & Coding
AWV codes (G0438–G0439) have specific documentation elements health risk assessment, cognitive assessment, functional status, and screening schedule. We make sure every AWV has what it needs.
Chronic Care Management Billing
CCM codes (99490, 99491, 99487) need documented time, a care plan, and patient consent. We track time and make sure care plans are in place.
Transitional Care Management Billing
TCM codes (99495–99496) have specific time windows for the face-to-face visit and interactive contact. We track the windows and make sure documentation supports the code billed.
Advance Care Planning Billing
Advance care planning (99497–99498) needs documented discussion, who was present, and time spent. We make sure these claims are coded right.
Nursing Home Visit Billing
Nursing home E/M codes (99304–99318) bill differently from office visits. We make sure POS matches where the patient was seen.
House Call Billing
House call codes (99341–99350) have their own documentation and travel rules. We make sure these claims hold up.
Dementia & Cognitive Assessment Billing
Dementia and cognitive assessments have specific codes and documentation requirements. We make sure these claims meet payer criteria.
Chronic Condition & Polypharmacy Billing
Geriatric patients with multiple conditions need E/M levels that reflect the complexity. We make sure visits are coded at the level the documentation supports.
Why Choose Med Bridge for Geriatrics Medical Billing?
Geriatrics-Specific Certified Coders
Our coders are certified (CPC, CCS) and work in geriatrics billing, not general medicine. They know AWV documentation elements, CCM time tracking, TCM windows, and nursing home POS rules.
Faster Reimbursement
97.9% clean claim rate. 24-day average A/R. 48-hour claim turnaround. These aren't marketing numbers; they're our actual performance metrics across 110+ geriatric providers.
Data Security & Compliance
SOC 2 Type II certified. HIPAA-compliant. We keep rigorous audit trails and send regular reports.
Scales With Your Practice
Solo geriatrician? Multi-provider group? House call practice? Our workflows scale without changing your EHR or adding staff.
In-House vs. Outsourced Geriatrics Medical Billing
| Cost Category | In-House Billing | Med Bridge Outsourced |
|---|---|---|
| Biller salary + benefits | $45,000–$65,000 / year | — |
| Billing software + clearinghouse | 7,000–$15,000 / year | Included |
| Geriatrics Coding Training | $2,000–$5,000/year | Included |
| Denial write-offs | 6–11% of revenue | 4.2% denial rate |
| Total annual cost | $60,000–$95,000+ | Percentage of collections no hidden fees |
| Net annual savings | — | $28,000–$55,000+ |
Frequently Asked Questions About Geriatrics Medical Billing Services
Geriatrics billing involves Medicare annual wellness visit coding, chronic care management time tracking, transitional care management windows, advance care planning codes, nursing home and house call POS rules, and coordination of benefits across Medicare and secondary payers. General billers miss these, and denials follow.
Yes. We work with independent geriatricians, geriatrics group practices, senior care clinics, house call practices, nursing home attending physicians, and PACE programs. Our workflows cover both office and facility billing.
You get monthly dashboards: clean claim rate, A/R days, denial rate by payer, claim turnaround time, AWV and CCM capture rates, and collections by service type. We also run ad-hoc reports for specific payers or service categories.
Denials get worked within 24–48 hours. Appeals include clinical documentation, coding rationale, and regulatory citations. We track denial reasons so we can fix root causes upstream, especially AWV coding errors and POS mismatches that recur in geriatrics.
Epic, Cerner, eClinicalWorks, athenahealth, NextGen, Allscripts, DrChrono, and Practice Fusion. If you use something else, we can work with your existing workflow or suggest an integration.
Pricing is a percentage of collections. No setup fees. No software fees. No hidden charges. You pay when you get paid.
We track authorization requirements per payer, submit requests with documentation that meets criteria, and coordinate with facilities so authorizations are in place. We follow the CMS Interoperability and Prior Authorization final rule for turnaround times.
Most practices are fully onboarded within 30–45 days. We handle the transition from your current billing company or in-house team, including EHR access, payer enrollment, care management setup, and geriatrics coding configuration.