Family medicine billing and coding
Primary care billing built for high volume and small margins
Family medicine sees many short visits with many payers. Small, repeated coding mistakes add up quickly across thousands of encounters.
What makes family medicine billing hard
Preventive plus problem visits
When a sick concern is addressed at a wellness visit, both can be billed, with modifier 25 on the problem E/M.
E/M levels
Choosing the level from medical decision making or time, consistently across providers.
Payer variety
Commercial, Medicare, Medicaid and managed-care plans each have their own rules.
Codes we see every day
Examples of the codes and modifiers our coders handle for this specialty.
| Code | What it describes |
|---|---|
| 99213 / 99214 | Established-patient office visits at low and moderate complexity |
| 99395 / 99396 | Preventive visit, established patient, ages 18–39 / 40–64 |
| G2211 | Medicare add-on for the ongoing complexity of longitudinal primary care |
| Modifier 25 | Significant, separately identifiable E/M on the same day as another service |
CPT codes and descriptions are summarised for readability. Always code from the current code set and payer policy.
How we help
- Code E/M levels consistently from documentation
- Capture problem visits addressed at preventive appointments
- Apply Medicare-specific codes such as G2211 where eligible
- Keep eligibility clean across many plans
Related services: Medical billing, Medical coding, Medical transcription, AI clinical documentation, Revenue cycle management, Denial management