Accurate Claims for Well Visits, Immunizations & Complex Pediatric Diagnoses
From newborn screenings and sick visits to ADHD management and vaccine reporting, our pediatric billing solutions ensure your practice gets reimbursed quickly and compliantly. Let us handle the CPTs, ICD-10s, and modifier logic—so you can focus on delivering care to kids of all ages.
Pediatric Billing Designed for Growing Practices
At RCM firms, we specialize in billing services for pediatric clinics, group practices, and multi-specialty centers. From infancy through adolescence, pediatric billing demands careful attention to age-based coding, vaccine admin reporting, and developmental screening documentation.
Our coders and billing experts understand the nuances of pediatric-specific CPT codes, modifier use for bilateral procedures, and payer policies for Medicaid, CHIP, and private plans. Whether you're managing acute visits, school physicals, or complex behavioral diagnoses—we ensure timely and accurate reimbursements.
What Sets Us Apart
- Billing for Well Visits, 99213–99215, and Preventive Services
- Vaccine Admin Codes (90460–90461) + NDC Tracking
- Newborn Hearing & Developmental Screening Billing
- Medicaid & CHIP Eligibility Verification
- EHR Integration with Office Practicum, PCC & eClinicalWorks
Mission Statement
We help pediatricians stay focused on children's health—not paperwork. Our mission is to simplify the revenue cycle so your pediatric practice thrives—whether you're seeing toddlers for wellness checks or teens for behavioral support.
Why Pediatricians Choose RCM firms
Pediatric billing requires more than just claims processing—it demands age-specific coding, growth milestone tracking, and careful management of vaccine administration codes. Our billing team handles everything from well-child visits to ADHD and asthma care, giving you peace of mind and faster reimbursements.
Preventive Visit Coding
We apply accurate CPTs for well-child checks by age, from infancy through adolescence, including risk assessment tools.
Immunization Billing & Tracking
We manage 90460–90461 coding with NDC tracking for vaccines, ensuring compliance with VFC and commercial payer rules.
Behavioral Health Support
Our team helps pediatricians bill for ADHD, autism, and depression screenings using proper HEDIS and CPT code sets.
School & Sports Physicals
We apply correct coding and documentation to ensure coverage—or proper cash flow—for non-covered physical exams.
Flexible Pediatric Billing Plans
Whether you’re managing a solo pediatric office or a multi-location practice, our pricing adapts to your size and service mix. Transparent rates. No long-term contracts. Just results-driven billing that aligns with your clinical care.
Group Practices
Perfect for multi-provider clinics or pediatric group networks.
What’s Included
- Claims for preventive, sick, and developmental visits
- Immunization tracking and vaccine reimbursement
- Eligibility checks for Medicaid & CHIP
- Monthly analytics and performance summaries
Need pricing for school-based health programs or rural clinics? We’ll tailor a plan that fits your pediatric billing goals.
Pediatric Billing in 4 Easy Steps
We make pediatric billing painless—from coding check-ups to resolving claim rejections. Our step-by-step system is designed for speed, accuracy, and peace of mind.
1
Practice Review & Code Mapping
We review your current CPT/ICD-10 usage, coding workflows, and payer contracts to identify improvement areas and reduce rejections.
2
System Setup & Payer Enrollment
We integrate with your EHR, enroll your providers with major payers, and set up custom fee schedules based on pediatric services.
3
Claim Coding & Submission
Each patient visit is reviewed and coded for accurate diagnosis and procedure matching, then submitted electronically within 48 hours.
Denial Follow-Up & Reporting
We chase down unpaid claims, appeal denials, and send monthly reports to help your pediatric practice grow stronger financially.
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Pediatric Visit Claim Accuracy
0 Days
Average Reimbursement Time
0%+
Avg Revenue Boost
End-to-End Billing Support for Pediatric Practices
From infancy to adolescence, our pediatric billing services cover every aspect of your care model. Whether you're coding a 2-month checkup or managing ADHD follow-ups, we help you collect every dollar you're owed—accurately and on time.
Well-Child Visits & Screenings
Proper use of age-specific CPTs (e.g., 99381–99385), developmental milestone coding, and risk assessments for accurate reimbursement.
Vaccine & Immunization Billing
End-to-end vaccine coding with 90460/90461, proper NDC logging, VFC management, and commercial payer compliance.
Sick Visits & Urgent Care
Billing for acute illnesses, follow-up visits, and complex E/M coding when time or medical decision-making exceeds the norm.
Behavioral & Developmental Billing
Support for ADHD, autism, anxiety, and behavioral screening codes (e.g., 96110, 96127), including documentation assistance.
Prior Authorizations
We obtain timely authorizations for ADHD meds, allergy testing, imaging, and referrals—reducing denials before they happen.
Pediatric Billing Analytics
Custom monthly reporting to track claims by age group, payer mix, denial rates, and more—so you can grow smarter.
Frequently Asked Questions
Answers to common questions from pain management clinics about interventional coding, payer rules, device billing, and authorizations.
Talk to a Pediatric Billing Expert Today
Whether you’re a solo pediatrician, part of a group, or managing a multi-location clinic, our billing solutions are customized for your workflows, visit types, and state-specific payer rules. Let’s explore how we can improve your collections.
IL 62701 United States