Internal Medicine Billing Services For Visits And The Care Between.
Internal medicine runs on volume and continuity: preventive visits that turn into problem visits, chronic conditions managed month to month, patients coming home from the hospital. Each has its own billing rules, and most of the revenue is in getting them right every day.
- Preventive and problem visits
- Care management programs
- Keep your existing EHR
Your PhysicianAddresses the visitNo real patient or claim data.
Three Preventive Visits, Three Sets Of Rules.
Patients and payers use "physical" loosely. Medicare does not. Choosing the right preventive service, and knowing when a problem visit is added, decides whether the claim pays and what the patient owes.
Welcome To Medicare Visit
Once, within the first 12 months of Part B coverage. Includes a review of history, risk factors and a written screening plan.
Annual Wellness Visit
First and subsequent visits. A health risk assessment and a personalized prevention plan, not a head-to-toe physical exam. No patient cost-sharing.
Routine Preventive Exam
Age-based comprehensive preventive exams. Often covered by commercial plans; Medicare does not cover a routine physical.
Revenue That Happens Between Appointments.
Much of internal medicine's work happens outside the exam room. These programs pay for it, when the time, consent and documentation are there.
Patients with two or more chronic conditions expected to last at least 12 months. Requires consent, a care plan and documented monthly time.
After a hospital or facility discharge: contact within 2 business days, then a visit within 14 or 7 days depending on complexity.
Device data and management time billed monthly. CPT 2026 added options for fewer days of data and shorter management time.
A Medicare add-on to office visits when you are the continuing focal point for a patient's care or for a serious condition.
Requirements summarized for Medicare; commercial plans vary. We confirm which programs your practice runs before billing them.
Visit Levels By Decision-Making Or Time.
Office visit levels are chosen by medical decision-making or by total time on the date of the visit, whichever the note supports better.
| Established visit | Medical decision-making | Or total time on the day, at least |
|---|---|---|
| 99212 | Straightforward | 10 minutes |
| 99213 | Low | 20 minutes |
| 99214 | Moderate | 30 minutes |
| 99215 | High | 40 minutes |
Time includes the physician's own work that day, such as reviewing results and documenting, not clinical staff time. We code the level the note supports and send a question when it is unclear.
Risk Adjustment Resets Every January.
For Medicare Advantage patients, chronic conditions count toward risk scores only when they are documented and addressed in a face-to-face or video visit with an acceptable provider each calendar year, with enough specificity in the diagnosis.
We code only what the note documents. When a condition is mentioned without assessment, or a diagnosis lacks specificity, we send your clinician a non-leading question instead of guessing.
Signs, symptoms, progression
Test results, exam findings
Status and the clinician's judgment
Medication, referral, plan
Medical Billing Or Full RCM?
Medical Billing
Your front desk keeps registration and eligibility. We bill preventive, problem and care management services from your notes and follow every response. Coding can be added.
About Medical Billing Services →Full RCM
We also check eligibility before visits, which matters for preventive frequency limits, and code every visit, with credentialing included.
About Full RCM →Care management programs are billed only when your practice runs them with the required consent, care plans and time records.
Questions Internal Medicine Practices Ask.
Please do not send patient records through the website.
Can You Bill A Wellness Visit And A Problem Visit Together?
Yes, when the note documents the problem separately. The problem visit carries modifier 25, and the patient may owe cost-sharing for it.
Do You Track Preventive Frequency Limits?
With Full RCM, eligibility checks include when a preventive service was last covered. With Medical Billing, your front desk keeps that check.
Can You Bill Chronic Care Management For Us?
Yes, if your team keeps consent, care plans and monthly time records. We bill from those records and flag months that fall short.
How Do You Handle Medicare Advantage Coding?
We code what is documented, with the specificity the note supports, and send non-leading questions when a condition is mentioned but not assessed.
What About Older Unpaid Visit Claims?
Inherited A/R older than 120 days is a separate recovery service. We review each claim's history and filing deadlines first.
Talk Through Your Practice Billing.
Tell us your visit volume, payer mix, any care management programs you run and how records reach billing. Please do not send patient records through the website.
- Preventive, problem and care management billing
- BAA signed before any patient-data access
- Medical Billing or Full RCM