Medical Billing for Internal Medicine Practices in Maryland: Maximize Accuracy, Minimize Denials

Internal medicine practices in Maryland are the backbone of adult care, often managing complex, chronic conditions and a high volume of patient visits. But when it comes to billing, even the most experienced internists can find themselves overwhelmed by shifting payer rules, E/M documentation changes, and claim denials.

At Global Tech Billing LLC, we specialize in helping internal medicine providers across Maryland increase collections, reduce A/R, and improve claim accuracy. This article explores how to simplify internal medicine billing, avoid the most common mistakes, and ensure your revenue cycle runs as smoothly as your clinical workflows.

Why Internal Medicine Billing Is So Complex

Internal medicine covers a wide scope—from diabetes management and hypertension to preventive screenings, chronic care, and telehealth. This diversity of services creates billing challenges that include:

• Choosing the correct E/M level
• Separating preventive and problem-based visits
• Managing high patient volume with accurate documentation
• Billing for chronic care, transitional care, and remote monitoring
• Complying with Maryland-specific Medicaid and MCO policies

These challenges are made worse by undertrained billing staff or generic billing companies unfamiliar with the nuances of internal medicine coding.

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Top CPT Codes Used in Internal Medicine

Knowing your most frequently billed codes—and how to use them correctly—can drastically improve your collections.

Evaluation & Management (E/M) Codes

• 99213 / 99214 / 99215 – Established patient visits
• 99203 / 99204 / 99205 – New patient visits
• 99495 / 99496 – Transitional care management (TCM)
• 99490 / 99487 / 99489 – Chronic care management (CCM)

Note: E/M codes now rely more on medical decision-making (MDM) and total time spent rather than bullet-point documentation.

Preventive Services

• 99385–99397 – Annual wellness visits
• G0438 / G0439 – Medicare annual wellness (initial and subsequent)
• 99406 / 99407 – Smoking cessation counseling

Preventive visits often include routine screenings. Be sure to separate these from problem-focused services with accurate ICD-10 coding.

Remote Monitoring & Virtual Care

• 99457 / 99458 – Remote physiologic monitoring
• G2012 / G2010 – Virtual check-ins
• 99441–99443 – Telephone E/M services

Telehealth services must be documented with time, patient consent, and platform used (HIPAA-compliant or not, depending on payer rules).

Key Billing Challenges for Internists in Maryland

1. Undercoding E/M Visits

Many providers default to 99213 even when the documentation supports a 99214 or 99215, resulting in significant revenue loss over time.

Solution: Use a time-based template or MDM tool within your EHR. At Global Tech Billing LLC, we audit charts to ensure proper level selection and help providers maximize compliant billing.

2. Not Billing Chronic Care Management

Chronic care management (CCM) codes can generate $40–$160+ per patient per month, yet many internal medicine clinics don’t use them.

Eligibility Criteria:

• The patient has 2+ chronic conditions
• Signed consent is obtained
• The care plan is documented
• 20+ minutes of non-face-to-face staff time per month

Tip: CCM is billable with most commercial plans, Medicare, and Medicaid MCOs in Maryland.

3. Denials for Split Preventive + Problem Visits

You can bill a preventive visit and an E/M visit on the same day—if you document them correctly.

Example:

• 99396 – Preventive visit
• 99214–25 – Same-day problem visit (e.g., for chest pain)

Modifier 25 must be used, and the documentation must support two distinct services.

CareFirst and UnitedHealthcare in Maryland often deny these claims if Modifier 25 is missing or if notes are not clear.

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Maryland Medicaid and Local Payer Trends

Internal medicine practices often deal with Maryland Medicaid (and its MCOs), Medicare, and commercial payers like CareFirst, Aetna, Cigna, and UHC. Each has unique quirks:

• Medicaid requires NDC numbers on some injectable claims
• CareFirst uses strict frequency edits for annual wellness and chronic care
• Medicare allows same-day billing for AWV and CCM but requires time-tracking

At Global Tech Billing LLC, we maintain payer-specific billing cheat sheets and real-time updates for Maryland practices to avoid compliance issues and speed up collections.

Best Practices to Code Smarter, Bill Faster

Verify Coverage & Benefits Before Every Visit

Train front desk staff to verify eligibility for AWVs, CCM, TCM, and vaccines. Many denials happen because of expired eligibility or frequency caps.

Use Modifiers Wisely

• Modifier 25 – Use with E/M + procedure on same day
• Modifier 59 / XU – Distinct procedural services
• Modifier 33 – Preventive services with no copay (ACA requirement)

Leverage Technology

Use billing software that:

• Tracks time for CCM and TCM
• Generates clean claims with payer-specific edits
• Flags coding inconsistencies in real-time

We help our Maryland clients integrate billing with their EHRs to reduce data entry errors and automate claim validation.

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Real-World Success Story

An internal medicine group in Anne Arundel County was experiencing a 20% denial rate and had never billed for CCM or TCM services. After working with Global Tech Billing LLC, they:

• Implemented CCM workflows and added $72,000/year in new revenue
• Reduced denials by 13% within 60 days
• Improved days in A/R from 43 to 28

We customized their billing rules, retrained front desk staff, and cleaned up their Medicare claims backlog—all within 90 days.

Why Internal Medicine Practices Trust Global Tech Billing LLC

With Maryland-specific payer knowledge and specialty-focused billing experts, we offer:

• Internal medicine coding expertise
• Chronic care and remote monitoring workflows
• Clean claim submission tailored to CareFirst, Medicare, and Medicaid
• Transparent dashboards and weekly performance updates

We don’t just bill—we partner with you to maximize reimbursements and minimize billing headaches.

Conclusion: Reclaim Your Revenue with Smarter Internal Medicine Billing

Internal medicine billing in Maryland doesn’t have to be frustrating or confusing. With the right billing partner, your practice can reduce denials, optimize claim accuracy, and start collecting what you truly deserve.

At Global Tech Billing LLC, we specialize in helping internists code smarter, stay compliant, and increase collections—whether you’re a solo provider or a busy multi-physician group.

FAQs

1. Can I bill a preventive and problem-based visit on the same day?
Yes. Use the appropriate preventive CPT (e.g., 99396) and E/M code (e.g., 99214–25) with clear documentation.

2. Is Chronic Care Management worth the effort?
Absolutely. Most internists already provide the care—CCM lets you bill for it. With a system in place, you can earn extra recurring revenue monthly.

3. What’s the biggest billing mistake internal medicine practices make?
Undercoding E/M levels and failing to bill for chronic care or transitional care services.

4. Do you handle billing for Medicare and Medicaid MCOs in Maryland?
Yes. We work with all Maryland Medicaid MCOs, Medicare, and commercial plans—offering payer-specific claim rules and compliance support. Visit our Maryland Billing Service page to learn more.

5. How quickly can I see results after switching to Global Tech Billing LLC?
Most clients see improved collections and reduced denials within 30–60 days, along with better A/R visibility