Physician Billing Services
Whether you are a solo practitioner or a large multi-physician group, MedPrecision's physician billing services are built around the unique requirements of professional fee billing. We code every encounter to the documentation and work each denial to its reason code. What a payer ultimately allows is its decision, not ours — so what we commit to is the work, not the outcome.
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What Are Physician Billing Services?
Physician billing services are the outsourced preparation, submission and follow-up of a practice's professional-fee claims — the CMS-1500 (electronically, the ANSI 837P) that a physician, nurse practitioner or physician assistant files for office, hospital and procedure encounters. The work is: code each encounter from the documentation, apply the modifiers the payer's edits require, submit the claim, work every denial to its reason code, post the payment, and report what was collected provider by provider. Cost: MedPrecision charges 7.0% of monthly collections for a solo practice and 6.0% for a group practice of 2–15 providers, charged on collections received rather than charges submitted — full pricing terms. This is a service practices buy; a patient holding a bill should contact the practice named on the statement.
- Fee structure: no setup fee, no implementation fee, no per-claim charge and no software fee, with EMR/EHR integration included — the solo tier carries a monthly minimum set in your quote, and enterprise groups are scoped separately
- Scope: CMS-1500 / 837P claims across 35+ specialties — E/M leveling, modifier 25/59/24/58 logic, global-period tracking, NCCI and MUE edits before submission
- Reporting: provider-level dashboards showing E/M distribution, RVU production and collection rate, per physician, every month
- For practices, not patients: if you are a patient paying a bill, ask the practice on your statement for the payer's remittance advice before you pay
Two different readers arrive at this page. If you are a patient trying to pay or query a medical bill, start with the practice or facility named on your statement — it owns the account, sets the balance and the payment terms, and is the only party that can explain or correct a charge; a billing company files claims on a practice's behalf and cannot adjust an account it does not own. Everything below is written for the other reader: the practice owner, office manager or physician deciding who prepares and files the practice's professional-fee claims, and what that costs — MedPrecision's published rate is 7.0% of monthly collections for a solo practice and 6.0% for a group practice of 2–15 providers, charged on collections received rather than charges submitted, with no setup fee, no per-claim fee and a monthly minimum on the solo tier (pricing in full). Physician billing runs on the CMS-1500 (ANSI 837P) and the Medicare Physician Fee Schedule (MPFS), where the 2021 AMA E/M coding guideline rewrite — followed by the 2023 split/shared and prolonged-service revisions — fundamentally changed how office-visit codes 99202-99215 and inpatient codes 99221-99239 are leveled. The new framework bases level selection on medical decision-making (MDM) complexity or total time, eliminating the prior history-and-exam scoring that practices spent two decades working around. Modifier logic is where physician billing breaks: modifier 25 (significant separately identifiable E/M with a procedure same day), modifier 59 with X-modifiers (XE, XS, XP, XU per CMS NCCI policy), modifier 24 (unrelated E/M during global), modifier 58/78/79 (related, unplanned, or unrelated procedure during global) — each with audit defensibility implications. MedPrecision's physician billing team specializes exclusively in CMS-1500 professional claims across 35+ specialties with provider-level scorecards, RVU productivity tracking, and coding audits run against the modifier and global-package rules those claims turn on.
Who This Service Is For
The State of Physician Billing Services in 2026
Where a physician's compensation is set on RVU production, the code assigned to an encounter moves two things at once: what the practice collects and what the physician is paid. So it is worth doing the arithmetic rather than quoting a survey. CY2026 has two Medicare conversion factors for the first time — $33.57 for qualifying alternative payment model participants and $33.40 for everyone else (the CY2020–CY2027 history, with the citation next to each figure). Run one office visit through it. On CMS's CY2026 relative value file, October release, read 17 September 2026, 99213 carries 2.85 total non-facility RVUs and 99214 carries 4.06 — $95.19 and $135.61 at the non-qualifying conversion factor, 33.4009 before rounding, a difference of about $40 on a single established-patient visit. A practice that bills the level 3 where its own documentation supports the level 4 gives up that $40 each time it happens, and commercial payers move it again on their own contracted schedules. How often it happens is the number that decides whether any of this matters, and it is the one nobody publishes: we have not seen a credible benchmark for under-coding frequency and do not quote one. It is measurable in a practice's own claims, which is why this work starts with a provider's E/M distribution read against their own notes rather than with an industry figure.
What Is Breaking Right Now
Under-coding of E/M visits due to provider documentation habits or fear of audits
Improper modifier usage causing claim denials or reduced payments
Lack of provider-level visibility into coding patterns and productivity
Revenue loss from missed procedures, add-on codes, or billable services
Common Physician Billing Services Mistakes to Avoid
Under-coding E/M visits out of audit fear rather than coding to documentation support
On CY2026 Medicare national non-facility amounts, 99213 pays about $95 and 99214 about $136. If the documentation supports the level 4 and the provider consistently codes the level 3, that is roughly $40 given up on each of those visits, and a different figure again on each commercial contract. How many visits it applies to is practice-specific: we have not seen a published benchmark for it and do not quote one, which is exactly why it is worth measuring in your own claims.
Conduct regular E/M coding audits that review documentation against assigned codes, provide individual provider feedback with specific examples, and educate providers on the 2021 AMA guidelines that make documentation-supported coding safe and defensible.
Not tracking individual provider coding patterns and productivity
Without provider-level data, under-coding, documentation issues, and productivity problems remain invisible. Providers have no basis for improvement, and practice leadership cannot make informed compensation or staffing decisions.
Implement provider-level dashboards showing E/M distribution, RVU production, collection rates, and peer comparison data. Review monthly and use as the basis for individual feedback and education.
Ignoring incident-to billing rules and billing opportunities
A service by a nurse practitioner or physician assistant that meets Medicare's incident-to requirements is billed under the supervising physician's NPI and paid on the full physician fee schedule amount; billed under the NPP's own NPI, the same service is paid at 85% of it. Practices that never test which encounters qualify leave that distinction unexamined in both directions — and billing incident-to where the supervision or documentation requirements were not met is a compliance exposure, not a revenue gain.
Educate providers and billing staff on incident-to billing requirements, configure billing rules to identify qualifying encounters, and audit compliance regularly.
Not reviewing fee schedules against current payer allowable amounts
Fee schedules that are not updated annually may charge below the maximum allowable amount for some services, and a payer pays the lesser of the billed charge and the allowable — so the practice is paid its own stale charge rather than the rate it contracted for. Charges set well above every payer's allowable carry the opposite problem and trigger audit scrutiny.
Review and update fee schedules annually against the Medicare Physician Fee Schedule and commercial payer contracted rates, setting charges at the highest allowable level across all payers.
What We Handle
E/M Coding Accuracy
Expert evaluation and management coding based on 2021 AMA guidelines, verifying your providers are not under-coding or over-coding office visits.
CMS-1500 Claim Management
Complete professional fee claim preparation, submission, and follow-up with attention to place-of-service codes, modifiers, and global period rules.
Modifier & Bundling Compliance
Correct application of modifiers 25, 59, 76, and others with NCCI edit compliance to prevent improper bundling and get the claim paid at the level the documentation supports.
Provider-Level Performance Reporting
Individual provider dashboards showing coding distribution, RVU production, collection rates, and benchmarking against specialty peers.
Provider Education & Feedback
Regular feedback to physicians on documentation patterns, coding opportunities, and compliance issues to improve capture rates at the source.
Fee Schedule Analysis
Annual review of your fee schedules against Medicare and commercial allowed amounts, so a charge still sitting below the rate you contracted for is found and corrected rather than carried another year.
Free Billing Audit · No obligation
Get a Free Billing Audit
Our team will review your physician billing workflow and show you where claims are stalling and what is causing it. Free assessment, no strings attached.
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A billing specialist will review your practice details and reach out within 1 business day. No confirmation email is sent — if you need to reach us sooner, call +1-872-297-2815.
Our Physician Billing Services Methodology
Provider-Specific Billing Configuration
Each physician's billing workflow is configured individually based on their documentation style, specialty focus, procedure mix, and payer contracts. A family medicine physician who does procedures has different billing needs than one who focuses on chronic care management. This individual configuration captures revenue that one-size-fits-all approaches miss.
E/M Level Optimization and Education
We analyze each provider's E/M coding distribution against specialty norms and their own documentation to identify under-coding or over-coding patterns. Providers receive specific feedback with encounter examples showing where their documentation supports higher coding levels, along with education on the 2021 AMA MDM and time-based coding guidelines.
Modifier Intelligence and NCCI Compliance
Our billing team maintains expertise in physician-specific modifier usage including Modifier 25 for significant separate E/M, Modifier 59 for distinct procedures, and Modifier 76/77 for repeat services. Every modifier is applied against the current NCCI edits, so a genuinely distinct service is reported as distinct and a bundled one is not unbundled.
Provider Performance Benchmarking
Individual provider dashboards show coding distribution, RVU production, collection rates, denial rates, and peer comparison data. This transparency enables physicians to understand their billing performance, identify improvement opportunities, and support performance-based compensation models with objective data.
Fee Schedule Optimization
Annual analysis of each provider's top CPT codes against Medicare and commercial allowed amounts identifies fee schedule gaps. Charges set below maximum allowable amounts are adjusted upward, and services that could benefit from renegotiated contract rates are identified for payer discussions.
Physician Billing Services: MedPrecision vs Alternatives
| Feature | MedPrecision | In-House | Other Providers |
|---|---|---|---|
| E/M Coding Expertise | 2021 AMA guidelines mastery with provider-specific tuning and education | Variable understanding of current E/M guidelines | Standard E/M coding without provider-specific tuning |
| Provider Reporting | Individual provider dashboards with coding distribution, RVU, and peer benchmarking | Aggregate practice reports without provider-level detail | Basic provider-level reports with limited benchmarking |
| Modifier Management | Specialty-informed modifier application with NCCI edit compliance validation | Conservative modifier usage, often missing billable services | Standard modifier application without specialty-specific tuning |
| Global Period Tracking | Automated surgical global period tracking preventing unbillable claims | Manual tracking prone to errors and missed global period violations | Basic global period alerts without full tracking |
| Provider Education | Quarterly individual feedback sessions with specific documentation improvement guidance | Informal feedback when problems are noticed | Annual group education without individualized coaching |
| Fee Schedule Analysis | Annual fee schedule tuning with payer contract rate comparison | Fee schedule updated only when problems are noticed | Basic Medicare rate alignment without commercial payer analysis |
“The revenue problem that recurs most in physician practices is not denial management or A/R follow-up, it is under-coding. A practice settles into billing every visit at one level because that is what the template defaults to, and the documentation supports a higher level on a share of them. We do not publish a dollar figure for what that is worth, because it depends entirely on your payer mix, your visit volume and how far the documentation actually goes -- and any company quoting you a per-provider number before reading your charts is guessing. What we do is pull the E/M distribution by provider, compare it against the documentation, and show you where the two disagree.”
MedPrecision Billing Team
Billing operations
How the Transition Works
How we deliver physician billing services for your practice.
Provider Workflow Analysis
We study each provider's documentation style, coding patterns, and specialty-specific billing requirements to configure our team for optimal results.
Encounter Review & Coding
Every encounter is reviewed for documentation completeness, coded to the highest supported level, and validated against payer-specific rules before submission.
Claim Submission & Adjudication Tracking
Claims are submitted electronically with real-time tracking of adjudication status, flagging any claims that stall or are improperly processed.
Provider Feedback & Revenue Growth
Monthly provider scorecards and quarterly education sessions identify documentation improvements that close the gap between what was documented and what was billed.
What Reporting and Visibility Looks Like
Transparency is built into every engagement. You will always know where your revenue stands and what actions are being taken on your behalf.
Monthly KPI Dashboards
Track collection rates, denial trends, days in A/R, and payer-level performance with dashboards delivered on a fixed schedule.
Real-Time Claim Tracking
See claim status updates in real time so you never have to wonder where a payment stands or when follow-up is happening.
Quarterly Business Reviews
Detailed reviews with actionable recommendations covering denial root causes, payer trends, and revenue recovery opportunities.
Proactive Alerts
Automated alerts when key metrics shift, so issues are caught and addressed before they affect your bottom line.
Physician Billing Services Key Terms
- CMS-1500
- The standard paper claim form used for professional fee billing by physicians and other non-institutional providers. The electronic equivalent is the ANSI 837P format.
- E/M Level
- The evaluation and management code level (1-5) assigned to an office visit based on the complexity of medical decision-making or total time spent. Under 2021 AMA guidelines, level selection is based on MDM complexity or total time.
- RVU (Relative Value Unit)
- A measure of the value of physician services used by Medicare and many commercial payers to determine payment. Each CPT code has an assigned RVU comprising work, practice expense, and malpractice components.
- Global Period
- The period of time following a surgical procedure during which related follow-up services are included in the surgical payment and should not be billed separately. Major surgeries have a 90-day global period; minor surgeries have 0 or 10 days.
- Modifier 25
- A modifier indicating a significant, separately identifiable evaluation and management service on the same day as a procedure. One of the most frequently used and most frequently audited physician billing modifiers.
- Incident-To Billing
- Medicare billing rules that allow services provided by non-physician practitioners under physician supervision to be billed under the physician's NPI at 100% of the fee schedule, rather than the 85% rate for NPP services. Requires specific supervision and documentation requirements.
Common Questions
Common questions about physician billing services.
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See where denials, follow-up delays, or workflow gaps may be hurting your collections.
Get a Free Billing AuditHow much do medical billers cost?
MedPrecision charges 7.0% of monthly collections for a solo practice and 6.0% for a group practice of 2–15 providers. The percentage is charged on collections received, not on charges submitted, so it moves with what the practice is actually paid. There is no setup fee, no implementation fee, no per-claim charge and no software fee, and EMR/EHR integration is included; the solo tier carries a monthly minimum, whose amount is set in your quote and Service Agreement rather than published here. Enterprise groups are scoped individually. The full terms, and what each tier includes, are on the pricing page. Most billing companies publish no rate at all, so when you compare, compare what a percentage covers — and compare it against the fully loaded cost of the in-house seat it replaces, not against a bare salary.
I received a bill from a doctor's office — can MedPrecision help me pay it?
No. MedPrecision is hired by practices, and this is a service page for practice owners rather than a patient payment portal. Contact the practice or facility named on your statement: it owns the account, sets the balance and the payment terms, and is the only party that can explain, correct or discount a charge. If the statement shows an insurance adjustment you do not recognise, ask that office for the remittance advice — the payer's written explanation of what it paid and why — before you pay.
How do you handle E/M coding under the 2021 AMA guidelines?
Our coders are fully trained on the 2021 E/M guidelines that base coding on medical decision-making (MDM) or total time. We review each encounter's documentation to assign the highest supported E/M level, provide feedback to providers on documentation improvements, and track coding distributions to identify improvement opportunities.
Can you bill for multiple providers with different specialties?
Yes. Each provider is assigned billers with expertise in their specific specialty. We maintain specialty-specific coding guidelines and payer rules while providing unified practice-level reporting. This is especially valuable for multi-specialty physician groups.
Do you handle surgical and procedure coding as well?
Absolutely. Our team handles the full range of physician CPT codes including surgical procedures, diagnostic tests, therapeutic services, and ancillary procedures. We manage global period tracking, multiple procedure discounting, and modifier application for surgical billing.
How do you help prevent compliance issues with physician billing?
We conduct regular coding audits, monitor documentation patterns for outliers, ensure modifier compliance with NCCI edits, and provide ongoing provider education. If we identify potential compliance risks, we flag them immediately with specific recommendations for correction.
Related Services
Specialties We Serve
Available In
- Physician Billing Services in California
- Physician Billing Services in Georgia
- Physician Billing Services in Florida
- Physician Billing Services in Arizona
- Physician Billing Services in North Carolina
- Physician Billing Services in Texas
- Physician Billing Services in Pennsylvania
- Physician Billing Services in New Jersey
Get a Free Billing Audit
Our team will review your physician billing workflow and show you where claims are stalling and what is causing it. Free assessment, no strings attached.
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