Specialty-Matched Billing
for Every Type of Practice
Generic billing loses money. Every specialty uses unique CPT codes, modifiers, and payer rules — and a billing team that doesn't know yours will leave revenue on the table every single month. Vector MB assigns specialty-specific billers to every client.
across all specialties
vs. 10–25% industry avg
dedicated billing teams
annually
experience
Why Generic Billing Costs Your Practice Money
Specialty-Specific CPT Codes
Chiropractic uses 98940–98943 with AT modifiers. Mental health uses 90837 with time-based documentation. Cardiology has complex bundling rules. Wrong code = automatic denial — and a generic biller won't catch it before submission.
Payer Rules Differ by Specialty
Medicare covers PT with a different therapy cap than chiropractic. Medicaid prior auth timelines vary by specialty. Behavioral health payers have separate documentation standards from medical ones. One billing team can't know all of these deeply.
Denial Rates Are Specialty-Driven
Mental health billing has 18–30% industry denial rates. Chiropractic runs 15–22%. A biller who handles your specialty every day knows the denial patterns before submission — not after the claim comes back.
Credentialing Requirements Vary
A peer support specialist needs different Medicaid enrollment documentation than a cardiologist. An orthodontist bills under a different provider type than a family physician. Wrong credentialing = every claim from that provider denies.
20+ Specialties. One Billing Partner.
Each card shows primary billing codes, typical denial risk, and what makes billing in that specialty uniquely challenging. Click to learn more about any specialty.
Chiropractic Billing
AT modifier compliance, CMT code selection (98940–98943), and Medicare active-complaint documentation. The AT modifier alone causes 30%+ of chiropractic denials when incorrectly applied.
Physical Therapy Billing
Time-based vs. service-based code selection, 8-minute rule compliance, Medicare KX modifier for therapy cap exceptions, and 97000-series code accuracy.
Orthopedic Billing
Surgical procedure coding, global period billing restrictions, fracture care codes, DME billing for orthopedic devices, and surgical assistant billing compliance.
Mental Health Billing
Psychotherapy time-based code selection, interactive complexity add-ons (+90833), telehealth parity compliance, and prior auth management for behavioral health payers.
Peer Support Services Billing
H0038, H0025, H2015, T1012 HCPCS coding. Critical modifier accuracy (-HF, -HQ, -U1/-U2), daily unit cap tracking, peer specialist credentialing, and Medicaid documentation compliance.
Cardiology Billing
Procedure bundling rules, stress test and echocardiogram coding, catheterization billing, device implant global period management. High-value codes with high denial risk from bundling errors.
Nephrology Billing
Dialysis billing (monthly capitation codes 90960–90961), ESRD-related service coding, chronic kidney disease E/M, and complex medication billing for dialysis patients.
Urology Billing
Cystoscopy, TURP, prostate biopsy, and urodynamic study coding. Global period management, modifier -51 bundling rules, and prior auth for surgical urology procedures.
Family Medicine Billing
E/M level selection under 2021 AMA guidelines, Annual Wellness Visit coding (G0438/G0439), preventive vs. problem-focused visit billing, and Medicare optimization.
Urgent Care Billing
High-volume claim processing, S9083 urgent care center code, split E/M vs. procedure billing, real-time eligibility for walk-in patients, and ER crossover denial management.
Dermatology Billing
Excision and destruction code selection by lesion size and type, shave vs. punch vs. excisional biopsy coding, and Mohs surgery multi-stage billing with correct pathology codes.
Ophthalmology Billing
Medical vs. routine vision code selection, intravitreal injection coding, cataract surgery global period management, and Medicare vs. vision insurance split billing.
Wound Care Billing
Debridement code selection by depth and method, skin substitute coding, negative pressure wound therapy billing, and wound measurement documentation for accurate code selection.
Diagnostic Lab Billing
Clinical lab panel billing, PAMA fee schedule compliance, molecular and genetic testing coding, and ABN waiver management for Medicare non-covered lab services.
Hospital Billing
Inpatient DRG optimization, outpatient APC coding, charge capture audits, UB-04 claim form billing, and complex payer contract compliance for facility revenue cycles.
Emergency Center Billing
ED E/M level selection (99281–99285), critical care billing (99291), split physician/facility billing, and trauma activation code compliance.
Private Medical Practices
Full RCM setup for independent practices — CMS-1500 billing, single or multi-specialty configuration, physician credentialing, and practice-level performance reporting.
Orthodontic Billing
Medical vs. dental billing split, functional appliance coding, surgical orthodontic pre-authorization, and insurance coordination for medically necessary treatment.
Medical Wellness Clinics
Preventive care coding, Medicare Annual Wellness Visits, chronic care management (CCM 99490), and hybrid billing for practices combining clinical and wellness services.
How Billing Complexity Differs by Specialty
Industry denial rates vary dramatically by specialty. This is why specialty-matched billing teams consistently outperform general billing companies — they know the failure points before submission.
| Specialty | Primary Codes | Denial Rate (Industry) | Modifier Complexity | Prior Auth Frequency | Key Billing Challenge |
|---|---|---|---|---|---|
| Chiropractic | CPT 98940–98943 | 15–22% | High — AT required | Moderate | AT modifier + active complaint documentation |
| Mental Health | CPT 90832–90853 | 18–30% | Medium | High | Time-based documentation, telehealth parity |
| Peer Support | HCPCS H0038, H0025 | 15–30% | High — HF, HQ, U-codes | Moderate | Modifier accuracy, unit caps, CPSS enrollment |
| Physical Therapy | CPT 97000-series | 10–18% | Medium — 8-min rule | Moderate | 8-minute rule, KX modifier, therapy cap |
| Cardiology | CPT 93000–93799 | 12–20% | High — bundling rules | High | Procedure bundling, global periods, devices |
| Orthopedics | CPT 27000-series | 14–22% | High — global periods | High | Global period restrictions, surgical assistants |
| Dermatology | CPT 11000–17999 | 8–14% | Medium | Low | Lesion size/type accuracy, destruction codes |
| Urgent Care | CPT E/M + S9083 | 8–15% | Low–Medium | Low | High volume, real-time eligibility, ER crossover |
| Family Medicine | CPT 99202–99215 | 6–12% | Low | Low | E/M level selection, preventive vs. problem |
| Ophthalmology | CPT 92000-series | 10–16% | Medium | Moderate | Medical vs. routine vision split, injections |
| Diagnostic Labs | CPT 80000-series | 8–13% | Low | Low | PAMA compliance, ABN waivers, panel bundling |
Industry denial rates are benchmarks. Vector MB clients across all specialties maintain denial rates below 4% through pre-submission specialty-specific code review and real-time eligibility verification.
One Process. Built for Every Specialty.
The same rigorous RCM workflow — with specialty-specific code rules, modifier matrices, and payer expertise built into every step for every specialty we serve.
Eligibility Verification
Real-time coverage check before every appointment — active enrollment, benefits, deductibles, prior auth, and specialty-specific plan requirements.
Documentation Review
Notes reviewed for specialty-specific requirements — time documentation, diagnosis linkage, procedure support, and payer-specific criteria.
Specialty Coding
CPT, HCPCS, ICD-10 assigned by billers who code that specialty daily — correct codes, correct modifiers, correct bundling.
Clean Claim Scrub
Payer-specific edit checks, bundling conflict review, modifier validation — every claim checked before it leaves our system.
EDI Submission
HIPAA-compliant electronic submission within 24 hours. Claim status tracked through adjudication with real-time updates.
Post, Appeal, Report
Payment posting, denial root-cause analysis, specialty-specific appeals, AR follow-up, and monthly performance reports.
Questions About Specialty Billing
Find Out How Much Revenue Your Specialty Is Leaving Uncollected
Most practices don't know their real denial rate until someone measures it. Our free billing audit shows exactly what's being lost — by specialty, by payer, by code — and how we stop it. No obligation.