Your Patients Get Your Full Attention. Your Billing Gets Ours.
Primary care practices see the broadest range of patients and conditions in medicine — which makes billing more complex than most providers realize. Theiatrics handles every layer of your revenue cycle so nothing gets undercoded, unbilled, or forgotten.
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Primary Care Is the Broadest Specialty to Bill. Most Practices Are Getting Less Than They Should.
Primary care physicians do more in a single day than almost any other specialist. They manage diabetes, hypertension, and depression — often in the same patient, in the same visit. They conduct preventive exams, handle acute complaints, coordinate specialist referrals, and provide telehealth follow-ups between office visits. Each of those encounters has its own billing rules, and getting any of them wrong costs real revenue.
The 2021 AMA E/M guideline update was the biggest change to primary care billing in a generation. Practices that adjusted their documentation and coding saw immediate gains. Many didn't — and are still billing lower E/M levels than their notes support, quietly leaving money behind on every single visit.
Beyond E/M coding, primary care has significant revenue opportunities that most practices aren't capturing at all. Chronic Care Management, Remote Patient Monitoring, Annual Wellness Visits, and transitional care management are all billable services that primary care provides routinely — but only gets reimbursed for when the billing is set up correctly.
Theiatrics manages all of it — not as a generalist billing company that handles primary care on the side, but as a team with deep, specific expertise in primary care revenue cycle management.
Built for Every Primary Care Setting
Internal Medicine Practices
Complex chronic disease management, high-acuity patients, and dense documentation — we code and bill it all with the precision internal medicine demands.
General Practice & Solo Physicians
Get the billing expertise of a full revenue cycle team without the overhead of hiring one in-house. Enterprise-level billing, accessible to independent practices.
Multi-Provider Group Practices
Consistent billing quality across every provider on your team — with scalable operations that grow as your group grows, without losing accuracy.
Community Health Centers (FQHCs)
FQHC billing has its own cost-reporting, encounter rate, and Medicaid rules. We understand them and help you maximize every dollar of federal reimbursement.
Telehealth & Hybrid Practices
Heavy virtual care volume means heavy reliance on telehealth billing accuracy. We keep every virtual visit coded correctly across every payer you work with.
Concierge & Direct Primary Care
Hybrid DPC models that also bill insurance require careful coordination. We handle the insurance billing side so your model stays clean, compliant, and financially viable.
End-to-End Primary Care Billing Services
Insurance Verification & Eligibility
We verify every patient’s coverage before their visit — benefits, deductibles, copays, referral requirements, and plan-specific restrictions. No billing surprises, no front-desk scrambles on appointment day.
E/M Coding & Charge Capture
Our certified coders apply the 2021 AMA E/M guidelines to every encounter — assigning the most accurate, defensible level based on medical decision-making or total time. No undercoding. No compliance risk.
Preventive Care & AWV Billing
We correctly code Annual Wellness Visits, IPPE, and commercial preventive exams — and manage same-day problem visits with the modifier 25 documentation that keeps claims clean and patients free from unexpected charges.
Chronic Care Management (CCM) Billing
CCM is one of the most consistently under-billed services in primary care. We set up the enrollment process, track monthly time, and bill 99490 and add-on codes correctly — turning care you already provide into reimbursement you're currently not capturing.
Remote Patient Monitoring (RPM) Billing
RPM programs for hypertension, diabetes, and other chronic conditions are billable monthly — but only when device setup, data transmission, and clinical review are documented correctly. We handle all of it.
Telehealth Billing
We apply the correct place-of-service codes, telehealth CPT modifiers, and payer-specific coverage rules to every virtual visit — and stay current as those rules continue to evolve across Medicare, Medicaid, and commercial plans.
Denial Management & Appeals
Every denial gets analyzed and appealed with payer-specific documentation. We don’t write off denied claims — we recover them. Our denial overturn rate reflects a process built on knowing exactly what each payer needs to reverse a decision.
Provider Credentialing
New providers joining your practice are enrolled with Medicare, Medicaid, and all relevant commercial payers before their first patient day. We manage applications, follow-ups, and re-credentialing — so there’s no billing gap from day one.
Reporting & Revenue Analytics
Monthly reports that give you real visibility — collection rates by payer, E/M level distribution, denial trends, AR aging, and revenue by service type. Know your practice’s financial health at a glance, every single month.
Revenue You May Be Missing
Primary Care Has More Billable Services Than Most Practices Realize
Beyond standard office visits, Medicare and commercial payers cover a growing range of care coordination and monitoring services – most of which primary care already provides, but rarely bills for.
The shift in primary care reimbursement has opened up new billing categories for care that happens between visits – phone check-ins, care coordination, remote monitoring, and proactive chronic disease management. These services are billable, reimbursable, and explicitly designed to reward primary care practices that provide them.
The catch is that capturing this revenue requires specific enrollment workflows, time-tracking processes, and documentation protocols that most practices haven't built. Without them, you're providing the service and absorbing the cost but not getting paid for it. Theiatrics builds these workflows for you, handles the billing, and ensures every qualifying patient and encounter generates the reimbursement it should.
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Chronic Care Management Often missed99490, 99439 20+ min/mo, Medicare patients with 2+ chronic conditions
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Remote Patient Monitoring Often missed99453, 99454, 99457, 99458 Device setup, data review, monthly clinical time
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Transitional Care Management99495, 99496 Post-discharge follow-up within 7 or 14 days
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Annual Wellness VisitG0438, G0439 Medicare preventive benefit – distinct from physical exam
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Advance Care Planning99497, 99498 Billable as standalone or add-on to AWV or E/M
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Principal Care Management99424, 99425 Single complex chronic condition, similar to CCM structure
- Why CCM Is the Biggest Missed Opportunity Most primary care practices have a large panel of Medicare patients with two or more chronic conditions – the exact population that qualifies for monthly CCM billing. A practice with 100 qualifying patients billing 99490 monthly adds meaningful annual revenue without adding a single visit to the schedule.
- RPM Is Growing Fast and Often Goes Unbilled Blood pressure monitors, glucometers, and pulse oximeters generate billable RPM data. The devices are already in patients' homes. The billing infrastructure, in most practices, hasn't caught up – which is exactly what we build and manage for you.
- Transitional Care Gets Forgotten Quickly After a hospital discharge, there's a billing window for transitional care management that closes in 14 days. Most practices miss it because no one has a workflow to catch the notification in time. We do, and we make sure it gets billed.
- Advance Care Planning Goes Unbilled Conversations about healthcare directives are billable and happen regularly in primary care. Adding 99497 to qualifying visits or as an AWV add-on costs nothing in clinical time but adds real, consistent reimbursement across your patient panel.
E/M Coding
The 2021 E/M Changes Are an Opportunity Most Practices Still Haven't Fully Captured
The 2021 AMA E/M revisions simplified the criteria for office and outpatient visit coding in a way that significantly benefits primary care. The old three-component system – history, physical exam, and medical decision-making – was replaced with a choice between MDM-based or total time-based coding. For complex primary care visits managing multiple chronic conditions, higher E/M levels are now justifiable based on clinical complexity alone.
In practice, many providers still document and code as if the old rules apply – defaulting to 99213 or 99214 out of habit when the visit clearly supports a higher level. Others have overcorrected and are billing high E/M levels without documentation to support them, creating audit risk on the other side.
Our coders are trained specifically on the 2021 guidelines and review each encounter to assign the most accurate, compliant E/M level – whether based on MDM or total time. The result is more accurate reimbursement and a documentation pattern that protects your practice in a payer audit.
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99202New Patient – Straightforward MDM 15–29 min total time
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99203New Patient – Low Complexity MDM 30–44 min total time
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99204New Patient – Moderate Complexity MDM 45–59 min total time
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99205New Patient – High Complexity MDM 60–74 min total time
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99213Established – Low Complexity MDM 20–29 min total time
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99214Established – Moderate Complexity MDM 30–39 min total time
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99215Established – High Complexity MDM 40–54 min total time
Why Theiatrics
Primary Care Billing Takes More Than Knowing the Codes
There's no shortage of medical billing companies willing to handle primary care. The difference is in the depth of knowledge — and that depth shows up in your collection rate, your denial rate, and the revenue from services you're currently providing but not billing for.
Billing a straightforward 99213 isn't hard. Correctly coding a 35-minute visit where a physician managed a patient's diabetes, hypertension, and new anxiety diagnosis, addressed a separate acute complaint, and ran a preventive screening — all billed correctly with the right modifiers and documentation — that takes genuine expertise.
Our team trains specifically on primary care billing. We know the nuances of the 2021 E/M guidelines, the CCM and RPM enrollment requirements, the AWV versus preventive exam distinction, and the telehealth rules that vary by payer. That knowledge is what turns an ordinary billing company relationship into a measurable revenue improvement for your practice.
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Primary Care Billing Specialists Dedicated coders trained on internal medicine and general practice — not generalists rotating across dozens of unrelated specialties simultaneously.
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CCM & RPM Revenue Activation We don't just bill what you send us — we identify and activate revenue streams like CCM and RPM that you're currently providing but not capturing.
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2021 E/M Guideline Mastery We apply the updated AMA guidelines correctly — optimizing your E/M levels based on what your documentation actually supports, not habit or outdated defaults.
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Performance-Based Pricing Our fee is a percentage of collections — so we only do well when you do well. Better billing means better outcomes for both of us, always.
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Works With Your EHR We integrate with athenahealth, Epic, eClinicalWorks, Kareo, DrChrono, and most other primary care platforms — your workflow stays exactly as it is.
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No Long-Term Contracts Month-to-month only. We earn your business by delivering results — and you're never locked into a contract that makes leaving difficult.
Find Out How Much Revenue Your Primary Care Practice Is Missing
Our free revenue audit reviews your E/M coding patterns, denial rate, and missed billing opportunities — and shows you exactly what more accurate billing is worth to your practice.
Schedule My Free Audit →Answers to What Primary Care Providers Ask Us Most
We believe in full transparency — no jargon, no runaround.
📞 Call Our Charge Team
Find Lost Revenue Before Claims Are Filed
We review recent encounters, identify missed or undercoded charges, and show exact revenue impact — before you commit to anything.
90 days of encounters reviewed
Codes matched with documentation
Exact dollar value identified
From certified specialists
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