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Internal and Family Medicine Billing: Get Paid for the Care You Already Give
Office Visits, Preventive Care and Care Management
Primary care practices see a high volume of office visits and provide a lot of care that never gets billed, such as care management between visits and wellness services. Billing Care Assistant helps internal and family medicine practices code every visit correctly and capture preventive and care management revenue that is often missed.
Common Primary Care Billing Problems We Fix
| Billing problem | Why it costs you | How we fix it |
|---|---|---|
| Preventive and sick visits on the same day | Payers deny the second service unless it is coded and documented correctly | We bill the preventive code plus a problem visit with modifier 25 when the record supports it |
| Annual Wellness Visit confused with a physical | Medicare covers the AWV (G0438, G0439) but not a routine physical | We code Medicare wellness visits correctly and use an ABN when a non-covered physical is done |
| Care management left unbilled | Chronic care management, transitional care and remote monitoring all pay | We help you track time and bill CCM, TCM and RPM when requirements are met |
| Visit levels under-coded | Choosing levels by habit instead of medical decision making or time leaves money on the table | We review documentation and code visits by decision making or total time |
| G2211 add-on missed | Medicare pays an add-on for ongoing, long-term care relationships | We add G2211 to eligible Medicare office visits |
Primary Care Services We Bill
Visits, prevention and care between visits
We code office visits (99202-99215) by medical decision making or time, preventive visits (99381-99397), Medicare Annual Wellness Visits, the Welcome to Medicare visit (G0402), vaccines with their administration codes, chronic care management (99490, 99439, 99487, 99491), transitional care management (99495-99496), remote patient monitoring, and the G2211 add-on for Medicare patients.
How We Keep Primary Care Claims Clean
High volume, done right
We verify eligibility before visits, check that diagnosis codes support each service, capture chronic conditions accurately for risk-adjusted plans, and scrub claims before they go out. Denials are handled by our denial management team. Learn more about CPT 99214 and the differences between internal and family medicine.
Payer Rules Primary Care Practices Should Watch
Small rules, big impact
Medicare covers one Annual Wellness Visit every 12 months and does not cover routine physicals, so patients may need an Advance Beneficiary Notice. Care management codes require patient consent, a care plan and documented time. Medicare Advantage and other risk-adjusted plans rely on complete, specific diagnosis coding. We help your team follow these rules so claims are paid and audits go smoothly.
Why Primary Care Practices Choose Billing Care Assistant
A partner for busy practices
You get coders who know primary care, help capturing care management and preventive revenue, and monthly reports by provider and payer. Want to see where your practice is losing revenue? Start with a free medical billing audit, or see all the specialties we bill for.
Internal and Family Medicine Billing FAQs
Can a preventive visit and a sick visit be billed on the same day?
Yes. If a significant problem is addressed during a preventive visit, the problem visit can be billed with modifier 25 in addition to the preventive code, as long as the documentation supports both.
Is the Medicare Annual Wellness Visit the same as a physical?
No. The Annual Wellness Visit focuses on a health risk assessment and a personalized prevention plan. Medicare does not cover a routine physical exam, so patients who want one may be responsible for the cost.
What is needed to bill chronic care management?
The patient needs two or more chronic conditions expected to last at least 12 months, consent on file, a comprehensive care plan, and at least 20 minutes of care management time in the month for code 99490.
What is G2211?
G2211 is a Medicare add-on code for office visits that are part of ongoing care for a patient’s health or a serious or complex condition. It is added to the visit code when the care relationship and documentation support it. See also our guide to CPT 99203.
Not Sure Where Your Revenue Is Leaking?
Get a free, no-obligation medical billing audit. We review your claims, denials and A/R, then show you what to fix first.
