Billing for endocrinology requires a nuanced understanding of chronic care management, complex diagnostic testing, and frequently changing payer rules related to metabolic disorders. From diabetes to thyroid disorders, endocrinologists treat conditions that require long-term management — which means billing must be precise, timely, and fully compliant to ensure consistent revenue.
Endocrinology Medical Billing Services
At Smart RCM Solutions, we specialize in accurate, efficient endocrinology medical billing that increases reimbursements, reduces denials, and gives your practice the financial health it deserves.
Challenges in Endocrinology Billing
- Multiple chronic conditions per patient
- Frequent follow-up and long-term care plans
- Extensive diagnostic and lab testing requirements
- Time-based billing complexities (e.g., prolonged services)
- Documentation issues with E/M code selection
- Frequent changes in payer policies for diabetes care, CGMs, etc.
- Delays due to prior authorizations and insurance verifications
Mistakes in coding or claim submission can significantly reduce revenue, especially for endocrinology’s high-volume services. That’s where expert billing makes the difference.
Our Endocrinology Billing Services
✔ E/M Coding Based on Complexity
We ensure your initial and follow-up visits are coded accurately (99202–99215) based on medical necessity and documentation.
✔ Chronic Care Management Billing
We support billing for CCM services (99490, 99487) to help your practice earn recurring revenue for managing complex patients.
✔ Diabetes Device & Lab Billing
We handle billing for Continuous Glucose Monitoring (CGM), insulin pump therapy, thyroid ultrasounds, A1C testing, and more.
✔ Accurate Modifier Usage
We use the correct modifiers (25, 59, 76, etc.) to ensure your diagnostic and evaluation services are reimbursed without bundling issues.
✔ A/R Follow-Up & Denial Management
We actively work on rejections, denials, and aging claims to keep your cash flow healthy and predictable.
Common Endocrinology CPT Codes
- 99202–99215 – New & established patient visits
- 99490, 99487 – Chronic care management
- 82947 – Glucose testing
- 83036 – Hemoglobin A1C test
- 95250, 95251 – CGM sensor placement and interpretation
- 96372 – Therapeutic injection administration
- 76536 – Thyroid ultrasound
- 36415 – Venipuncture for lab draw
We ensure proper documentation and modifier use so none of these procedures are denied or underpaid.
Who We Serve
- Solo Endocrinologists
- Endocrinology Specialty Clinics
- Multispecialty Practices
- Hospital-Based Endocrinology Providers
- Weight Loss & Hormonal Therapy Centers
- Diabetes & Thyroid Care Clinics
Whether you’re focused on diabetes management, hormonal disorders, or advanced endocrine diagnostics — we adapt our billing workflow to your specialty focus.
Why Choose Smart RCM Solutions?
✅ In-depth knowledge of endocrinology billing & coding
✅ Dedicated billing team with 24–48 hour claim turnaround
✅ Accurate use of ICD-10 codes for chronic endocrine conditions
✅ HIPAA-compliant workflows and EHR integration
✅ Transparent reports on collections, denials, and aging
✅ Monthly performance reviews and optimization suggestions
We’re not just a billing company — we’re your revenue partner. When your endocrinology billing is handled by experts, you focus more on improving patient outcomes and less on paperwork.
FAQs – Endocrinology Billing
Q: Can I bill for both a visit and diagnostic test on the same day?
Yes, if both services are medically necessary and properly documented, and with correct modifier usage (e.g., modifier 25).
Q: How do you bill for CGM (Continuous Glucose Monitoring)?
We bill CPT 95250 for sensor placement and 95251 for interpretation. These codes require correct timing and documentation to avoid denials.
Q: Can endocrinologists bill for chronic care management (CCM)?
Yes, if your practice meets the time requirements and has consent from the patient, we can bill 99490 and related codes monthly.
Q: What if a claim is denied due to “non-covered service”?
We review payer-specific policies, appeal claims with supporting documentation, and contact patients for alternate payment arrangements if needed.
Focus on Care. We’ll Handle the Billing
Your role in managing chronic conditions is life-changing — and your revenue cycle should support that. At Smart RCM Solutions, we take the stress out of endocrinology billing with a proven system built for specialists like you.
📩 Email: [email protected]
🌐 Visit: www.SmartRCMSolutions.com