Specialized medical billing solutions designed for Nurse Practitioners across all 50 states. We handle your revenue cycle end-to-end — so you can focus on patient care, not paperwork. (Nurse Practitioner Billing Services In USA)
Why NP billing is different
Nurse Practitioners face unique billing challenges that general billing companies often miss.
Incident-to vs. independent billing: Knowing when to bill under the supervising physician’s NPI vs. the NP’s own NPI can dramatically affect reimbursement rates.
State-by-state scope of practice: Full practice authority, reduced practice, and restricted practice states each have different billing rules and payer policies.
Medicare reimbursement at 85%: NPs are reimbursed at 85% of the physician fee schedule. We ensure every claim is coded to maximize this rate.
Credentialing requirements: Getting enrolled with Medicare, Medicaid, and commercial payers under your own NPI requires expert credentialing support.
Our NP billing services
End-to-end revenue cycle management tailored for Nurse Practitioners.
Medical coding: Accurate ICD-10, CPT, and HCPCS coding by certified coders who specialize in NP documentation requirements.
Claims submission: Electronic claim submission within 24–72 hours of service. We verify eligibility before every claim goes out.
Denial management: We identify denial patterns, fix root causes, and appeal all denials on your behalf — fast.
AR follow-up: Proactive accounts receivable follow-up to reduce aging balances and accelerate your cash flow.
Credentialing: NPI enrollment, CAQH setup, and payer credentialing so you can bill independently from day one.
Reporting & analytics: Monthly financial reports, KPI dashboards, and transparent performance tracking you can act on.
Common NP billing CPT codes we handle: Our team is experienced with the full range of codes used in NP practice settings.
| CPT code | Description | Setting |
|---|---|---|
| 99213 – 99215 | Office / outpatient E&M visits (established patient) | Outpatient |
| 99202 – 99205 | Office / outpatient E&M visits (new patient) | Outpatient |
| 99232 – 99233 | Subsequent hospital inpatient care | Inpatient |
| 99347 – 99350 | Home visit E&M services | Home |
| G0402 | Medicare annual wellness visit (Initial) | Preventive |
| 99495 – 99496 | Transitional care management | TCM |
How our billing process works
A simple, transparent 6-step workflow from service to payment.
Onboarding: We review your current billing setup and identify gaps.
Credentialing: Enroll your NPI with all required payers.
Charge capture: Accurate coding from your clinical documentation.
Claim submission: Clean claims submitted electronically within 72 hours.
Payment posting: ERA/EOB processing and patient balance billing.
Reporting: Monthly reports with collections, denials, and KPIs.
Frequently asked questions
Common questions from Nurse Practitioners about medical billing.
Can Nurse Practitioners bill Medicare independently?
Yes. NPs can bill Medicare directly under their own NPI and receive 85% of the physician fee schedule rate. Our team ensures your claims are submitted under the correct NPI and with the right rendering provider information to avoid reductions or denials.
What is incident-to billing and when should it be used?
Incident-to billing allows an NP’s services to be billed under the supervising physician’s NPI at 100% of the fee schedule, but only when strict requirements are met. Our coders evaluate every encounter to determine the most compliant and financially beneficial billing method.
Do you handle billing for telehealth services by NPs?
Absolutely. We are experienced with telehealth-specific codes, place-of-service modifiers (POS 02/10), and the latest CMS policies for NP telehealth reimbursement across all major payers.
How long does the credentialing process take?
Medicare credentialing typically takes 60–90 days. Commercial payer enrollment can range from 45 to 120 days depending on the payer. We begin this process immediately upon onboarding so there is no delay in billing.
What states do you serve?
We provide nurse practitioner billing services across all 50 states in the USA. Our team is well-versed in state-specific scope-of-practice laws, Medicaid billing rules, and payer policies that vary by geography.
Ready to optimize your NP revenue cycle?
Get a free billing audit and see exactly how much revenue your practice may be leaving on the table.
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📧 Email: support@malakoshcs.com
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📍 Address: 2232 Dell Range Blvd, Ste 242 #5791, Cheyenne, WY 82009, USA