Specialty billing

Primary Care Billing Services

Primary care runs on high visit volume and a lot of small details. A single day can include preventive and problem visits, wellness exams, care management time and vaccines, and each of these has its own rules.

Rules to watch

  • Modifier 25 documentation on same-day services
  • Frequency limits on preventive services
  • G2211 visit complexity add-on eligibility for Medicare
  • Care management consent and time tracking
  • Eligibility checks for high-volume scheduling

How does primary care billing work?

Primary care billing turns a high volume of short visits into clean claims, and most of the money is in the details. A typical day mixes problem visits coded by E/M level, age-based preventive visits, Medicare annual wellness visits, vaccines and care management time. Several of these can land on the same date, so modifier 25, frequency limits and documentation decide what gets paid. Internal medicine practices see more chronic care management and Medicare G-codes; family medicine adds more pediatric preventive care and vaccines. Either way, the usual leaks look alike: a wellness visit billed as a physical, care management minutes that were never captured, and a same-day sick visit left off the claim because nobody added the modifier.

What makes it different

What makes primary care billing different

Same-day preventive and problem visits

When a significant problem is addressed during a preventive visit, both services may be billable with the right documentation and modifier 25.

Wellness vs. physical

Medicare annual wellness visits (G0438 and G0439) are different from a routine physical, and payers treat them differently.

Care management time

Chronic care management (such as 99490) and transitional care management (99495–99496) depend on time and documentation requirements.

Vaccines

Vaccine product codes must be paired with the correct administration codes, and coverage differs by payer and age.

Codes at a glance

Common primary care codes and what to watch

ServiceCodesWhat to watch
Office visits99202–99205 (new), 99211–99215 (established)Level set by medical decision making or total time
Preventive visits99381–99387, 99391–99397Coded by age; a separate problem visit needs modifier 25
Medicare wellness visitG0438 (initial), G0439 (subsequent)Not the same service as a routine physical
Chronic care management99490 (first 20 minutes)Patient consent and time tracking required
Visit complexity add-onG2211Medicare; ongoing care relationship documented

Related services

Services that matter most for primary care

Medical Billing

We handle charge entry, claim submission, payment posting and follow-up.

Medical Coding

ICD-10-CM, CPT and HCPCS codes are assigned from clinical documentation.

Claims Management

Claims are scrubbed, submitted and tracked, and rejections get corrected.

Denial Management

Denials are corrected, appealed and traced to their root cause.

FAQ

Primary Care billing questions

Can a preventive visit and a sick visit be billed on the same day?

Often, yes, as long as a significant, separately identifiable problem is addressed and documented. The problem-oriented E/M is typically reported with modifier 25. Payer policies vary, so documentation matters.

What is the difference between an annual wellness visit and a physical?

A Medicare annual wellness visit focuses on a personalized prevention plan and health risk assessment and does not include a comprehensive physical exam. A routine physical is a different service with different coverage rules.

How do I choose between 99213 and 99214?

It depends on the level of medical decision making or the total time on the date of the visit: low MDM or 20 minutes or more supports 99213, and moderate MDM or 30 minutes or more supports 99214. Our 99213 vs. 99214 guide walks through it.

Coding rules change every year. The code references on this page reflect general guidance at the time of writing. Payer policies and your documentation always determine what is billable.

Let’s take a closer look at your revenue cycle

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