Primary Care Billing Articles & Guides

Primary care billing has evolved significantly in recent years, with new code structures and value-based payment programs creating both opportunities and challenges for family medicine and internal medicine practices. The 2021 E/M documentation guideline changes shifted office visit leveling from the traditional history, exam, and medical decision-making framework to one based primarily on medical decision-making complexity or total time. Practices that have not adapted their documentation habits to align with these changes frequently undercode, leaving significant revenue uncaptured at the 99214 and 99215 levels.

The introduction of HCPCS code G2211 as an add-on for ongoing primary care relationships represents a major new revenue stream that many practices fail to capture. When billed appropriately with qualifying office visits, G2211 can generate substantial additional annual revenue per provider. Similarly, Chronic Care Management (CCM) codes 99490, 99439, and 99491 allow practices to bill for the non-face-to-face care coordination work that primary care physicians have historically performed without compensation. Transitional Care Management (TCM) codes 99495 and 99496 for post-discharge follow-up and Annual Wellness Visit (AWV) codes G0438 and G0439 offer additional revenue opportunities that require systematic workflows to capture consistently.

Despite the breadth of billable services available, many primary care practices operate on thin margins because they lack the billing infrastructure to capture every eligible code. Medtransic helps primary care practices implement comprehensive charge capture systems that ensure E/M visits are leveled accurately, G2211 is appended when appropriate, and care management programs generate the recurring revenue they were designed to produce. Our billing specialists understand the nuances of primary care coding and work with practice teams to close revenue gaps without adding clinical documentation burden.

Primary Care Billing Articles

• Primary Care Billing Services: E/M Leveling, G2211, and the Revenue Opportunities Most Family Practices Miss - Primary care billing looks simple on the surface — office visits, preventive exams, and vaccinations. But E/M leveling errors, missed G2211 add-on revenue, unbilled chronic care management, and the preventive vs. problem-oriented split create a gap between what practices earn and what they should be collecting. (16 min read)