Specialty
Internal Medicine Billing and RCM
Complex patients. Multiple conditions. Visits that combine prevention with problem management.
Why it’s different
Internal medicine isn't simple sick visits. It's managing diabetes, hypertension, heart disease — often all in the same twenty minutes.
E/M coding must reflect medical decision-making complexity, and payers scrutinize level 4 and 5 visits harder here than almost anywhere else.
Common challenges
Where the money goes missing.
- E/M Level Selection
- Levels that don't match the documented decision-making, in both directions.
- Preventive + Problem Visits
- Modifier 25 required when a problem is addressed at a preventive visit, and frequently missing.
- Chronic Care Management
- CCM time is spent and documented, then never billed.
- Medicare Annual Wellness Visit
- AWV confused with a routine physical — different benefit, different code, different coverage.
- Multiple Condition Coding
- Diagnoses that support the complexity of the visit left off the claim.
How we help
We review every charge before submission. We check E/M levels against documentation. We flag missing opportunities like CCM and TCM. We review codes for accuracy.
We do not provide coders. Your providers document, your clinical team assigns the codes, and we verify and validate them before the claim goes out.
Key codes
- CPT 99202–99215
- CPT 99381–99397
- CPT 99490
- Modifier 25
- Modifier 59
Indicative, not exhaustive. Code sets and payer policies change.
Get an Internal Medicine Billing Analysis
Send us a sample of your denials. We'll tell you what's actually driving them in your specialty.