Medical billing for Pediatrics requires taking into consideration that Pediatricians spend approximately 25% more time with their patients as compared to other specialty practices, and oftentimes will provide several complex and more comprehensive services to their patients. The pediatric practices need experienced and knowledgeable Pediatric coding and billing experts to help Pediatric practices best support their patients, and not worry about capturing the maximum revenue for the services they provide to patients.

  1. Increase Patient Visits and Appointments:

Digital marketing for Pediatrics is very critical. Now more than ever, the online presence is so important with patients selecting their new pediatrician through online searches, and seeking pediatric practices who present with the highest review scores possible within their search area.

Pediatric practices need to hire healthcare digital marketing companies ( to work hand-in-hand with their pediatric practice to ensure the website has the most impactful online presence required to reflect the highest number of positive patient reviews, pops to the top of the list through online searches and shares relevant posts within social media and pediatric reviews.

2. Apply Accurate Pediatric E&M Codes

Pediatric billing involves billing things adjacent to the care also, like meeting with parents or consulting medical records etc. A deep knowledge of E&M codes is required so that pediatricians get paid promptly for everything they do, not just the obvious. It is essential for pediatricians in particular to clearly understand the guidelines in place for the billing and reporting of Evaluation and Management codes for each visit. One of the key factors to consider for pediatricians is the time-based component when counselling and coordination of care are provided, which can account for up to 50% of the time spent with the patient and/or the family. It is equally as important to consider the non-face-to-face time with the patient, which can also be a key factor when considering the level of coding, which includes the time spent reviewing records and tests, arranging for other services with healthcare professionals and coordination of care etc.

3. Ensure to Bill Complex Procedures

Pediatric procedures have a wide range. Few pediatric practices may miss on billing CPT codes related to complex procedures. Applying accurate CPT codes for specialized pediatric services is critical. Below are few illustrative examples of CPT codes and are subjected to change periodically

· 31500: intubation, endotracheal; emergency procedure,

· 36011: central venous catheterization or cannulation;

· 36400: venepuncture, under age 3 years;

· 36660: catheterization, umbilical artery, new-born;

· 36620: arterial catheterization or cannulation;

· 51702: insertion of indwelling bladder catheter;

· 54150: circumcision, using a clamp or other device;

· 62270: spinal puncture, lumbar, diagnostic;

· 90782: therapeutic, prophylactic or diagnostic injection;

· 90788: intramuscular injection of antibiotic;

· 92551: screening test, pure tone, air only;

· 92567: tympanometry (impedance testing);

· 92950: cardiopulmonary resuscitation;

· 94200: maximum breathing capacity, maximal voluntary ventilation, and more

· 99141: sedation (conscious sedation); intravenous, intramuscular or inhalation;

· 99173: screening test of visual acuity, quantitative, bilateral;

4. Get experts on your EHR Systems

It is important that the billing company or staff that Pediatric hire are expert in the EHR/PM system they use. For pediatric medical billing on Allscripts or for pediatric medical billing on eClinicalWorks or for pediatric billing on Dr Chrono or pediatric medical billing on AdvancedMD, contact us at

5.Customized Reports and Analytics for Pediatrics

Pediatric practice analytics has few key aspects such as practice dashboard, denial analysis, account receivable analysis, waterfall analysis, payment forecasting, carrier collection analytics and more. Pediatrician should evaluate their billing company for the kind of reporting and analytics they will provide so that your pediatric practice performance improves.

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