Medical Billing Services for Nurse Practitioners
Specialized billing support for NPs in primary care, psychiatry, FNPs, ENPs, adult-gerontology, telehealth providers, mobile clinics, and independent NP practices.
Nurse practitioners face unique billing challenges — strict documentation rules, split/shared visit policies, incident-to requirements, telehealth variability, and payer-specific coding guidelines. Global Tech Billing provides specialty-aligned medical billing for NPs with an emphasis on compliance, clean claims, fast payment cycles, and denial prevention.
Why Nurse Practitioners Need Specialty-Specific Billing
Billing for NPs is not the same as billing for physicians. You need a billing partner that understands NP-specific rules, reimbursement, and compliance requirements.
NPs are often reimbursed at lower rates than physicians — every clean claim and correct code matters.
Documentation and billing for split/shared visits must meet strict payer criteria.
“Incident-to” billing rules and eligibility vary — mistakes trigger audits and recoupments.
NP-specific Medicare and Medicaid policies require correct enrollment, taxonomy, and coding.
Telehealth rules, POS codes, and modifiers differ by payer and state — especially for NPs.
Scope-of-practice laws impact billing, supervision, and how services can be reported.
Preventive visits, AWVs, and problem-oriented add-ons need precise coding to be paid correctly.
Primary care and mental health NPs rely on time-based coding — documentation must support it.
Supervising physician requirements are state-dependent and impact how services can be billed.
Why Global Tech Billing is the Right Partner for NPs
High First-Pass Acceptance
92–95% first-pass acceptance rate for NP claims, so more visits get paid on the first submission.
Fast Claim Submission
Claims submitted within 24–48 hours to keep your cash flow consistent and predictable.
NP-Specific Coding Support
Accurate NP-specific coding and documentation guidance to match payer rules and prevent red flags.
Incident-To & Shared Visit Rules
Deep knowledge of incident-to, split/shared visits, and direct NP billing rules across payers.
Daily A/R Follow-Up
Daily follow-up on unpaid and underpaid claims until they’re fully resolved — no balances forgotten.
Flexible NP Pricing
Flexible pricing for low-volume NPs and new practices so you’re not penalized while ramping up.
Built for Modern NP Models
Support for independent NP practices, telehealth, mobile clinics, and concierge-style care models.
Works With Your EHR
Works with major EHRs used by NPs: Athena, eClinicalWorks, AdvancedMD, Kareo, SimplePractice, CharmHealth, and more.
Services We Provide for Nurse Practitioners
End-to-end billing and revenue cycle support designed specifically for nurse practitioners in primary care, psychiatry, telehealth, mobile clinics, and independent NP-led practices.
Eligibility & Benefits Verification
We verify coverage, copays, deductibles, and NP-specific benefits before the visit to prevent avoidable denials.
NP-Specific Coding Support
Coding support for preventive visits, E/M, telehealth, and in-office procedures tailored to NP scope and payer rules.
Telehealth Billing Compliance
Correct POS codes, modifiers, and payer-specific telehealth rules for NP virtual care.
Prior Authorization Management
Full management of medication, imaging, and service authorizations so your team can stay clinical.
Claim Creation & Submission (24–48 Hours)
Clean, accurate claim creation and submission within 24–48 hours of receiving documentation.
Denial Management & Appeals
Root-cause analysis, corrected claims, and formal appeals to recover NP claim revenue.
A/R Recovery & Daily Follow-Up
Active A/R recovery with daily follow-up until each unpaid or underpaid claim is fully resolved.
ERA/EOB Posting
Accurate ERA/EOB posting with proper adjustments, write-offs, and patient balance updates.
Patient Statements (Optional)
Optional patient billing support, including clear statements and soft-collections workflows.
Monthly Revenue & Performance Reporting
Monthly reports on collections, denials, payer mix, and performance trends for your NP practice.
Virtual Medical Scribe Support (Optional)
Optional Virtual Medical Scribe support to speed documentation and reduce coding and charting errors.
Our Billing Workflow for Nurse Practitioners
Patient Eligibility & Benefits Verification
We verify coverage, copays, deductibles, mental health/primary care benefits, prior auth requirements, and incident-to rules before the patient is seen.
Documentation Review & Virtual Scribe Support
If you use our Virtual Scribe, your notes are documented accurately and ready for coding. We review all documentation for completeness to avoid missed elements that cause denials.
Claim Creation & Submission (24–48 Hours)
Clean, accurate NP claims prepared and submitted within 24–48 hours to maintain a predictable revenue cycle.
Accurate Coding, Modifier Use & Denial Prevention
We ensure correct CPT coding, time-based E/M selection, incident-to compliance, and precise modifier use (SA, 25, 59, 95) to prevent NP-specific rejections.
Daily A/R Follow-Up Until Resolved
Every unpaid claim gets consistent daily follow-up. We contact payers, correct issues, and push each claim to full resolution.
Monthly Revenue & Performance Reports
Clear monthly reports showing collections, denials, payer behavior, and opportunities to improve documentation or coding.
Audit, Compliance & Recoupment Support
We assist with payer audits, documentation requests, recoupment notices, and compliance reviews to keep your practice protected and aligned with regulations.
Common CPT Codes, Denials & Modifiers for Nurse Practitioners
Real-world NP billing details we work with every day — from CPT codes and frequent denial reasons to the modifiers that make or break your reimbursements.
- 99202–99205 — New patient
- 99211–99215 — Established patient
- 99381–99387 — New patient preventive visit
- 99391–99397 — Established patient preventive visit
- 36415 — Venipuncture
- 81001 / 81002 — Urinalysis
- 93000 — ECG
- 90471–90474 — Immunization administration
- 99281–99285 — Emergency services (for ENPs)
- 99490 — CCM 20 min
- 99439 — CCM add-on
- 99406 / 99407 — Smoking cessation
- G0438 / G0439 — Medicare Annual Wellness Visits
- 99212–99215 — Office/OP E/M with telehealth POS
- 99422–99423 — Online digital E/M
- 99441–99443 — Telephone visits (payer dependent)
- Missing supervising physician requirements
- “Incident-to” billed incorrectly
- Provider not credentialed or not linked to group NPI
- Scope-of-practice violations
- Missing time documentation for E/M codes
- Preventive visits billed incorrectly with problem visits
- Telehealth POS or modifier mismatch
- Procedure codes not allowed for NP specialty taxonomy
- Medicare: missing NPI linkage in PECOS
- CO-16 — Missing/incorrect information
- CO-197 — Provider not eligible / not authorized
- CO-50 — Non-covered service
- PR-119 — Benefit maximum reached
- CO-151 — Provider type not eligible
- CO-96 — Non-covered charge (often incident-to issues)
We catch these patterns early with NP-specific edits and scrub rules — before they turn into lost revenue.
- Modifier 25 — Significant, separately identifiable E/M and procedure on the same day.
- Modifier 59 — Distinct procedural service.
- Modifier 95 — Synchronous telemedicine service.
- Modifier GT — Telehealth (payer dependent).
- Modifier SA — Nurse practitioner rendering service.
- Modifier GP — Services under therapy plan (used by some NPs).
- Modifier 24 — Unrelated E/M during post-op period.
- Modifier 57 — Decision for surgery.
Modifier SA is especially critical for commercial payers (BCBS, Aetna, Cigna, UHC) when NPs render services — incorrect use can mean reduced payment or denials.
Transparent Pricing for Nurse Practitioners
Transparent and flexible for NP practices:
Ideal for higher monthly volume NP clinics with consistent patient flow.
Designed for solo providers, and new practices who are still ramping up.
Get Started Today
We’ll help you reduce denials, increase collections, and simplify your entire billing workflow.
