Pediatrics Billing & RCM
Pediatrics billing and revenue cycle, 50-state coverage.
Pediatrics billing and revenue cycle services from ASP-RCM Solutions. 19,957 NPPES pediatrics billing providers across all 50 states + DC. BHCOE channel partner. HIPAA + SOC 2 Type II compliant. Senior partners on every account.
What good pediatrics billing execution looks like.
The operating discipline we install on every pediatrics billing engagement.
- Well-child visit + vaccine coding accuracyWell-child visits (99381-99385) plus vaccine administration (90460-90474) and vaccine product J-codes drive significant pediatric revenue. your state pediatric practices need accuracy across vaccine inventory and admin coding.
- EPSDT screening + bright futures alignmentyour state Medicaid program EPSDT screening for under-21 beneficiaries follows Bright Futures schedule. your state pediatric practices need EPSDT-specific coding (W modifier or state-specific equivalents) plus referral management.
- Behavioral health screening + integration codesPediatric BH screening (96127), depression screening (G0444), and Behavioral Health Integration (BHI) coding capture significant revenue otherwise missed.
- Sick visit + procedure same day (mod 25)Same-day sick visit plus procedure (laceration repair, ear lavage, asthma treatment) requires defensible modifier 25 documentation.
- Newborn care + circumcision billingNewborn care (99460-99465) and circumcision (54150 or 54160) require accurate facility vs office distinction and timely billing.
- Prior authorization for ABA and specialty referralsyour state pediatric practices generating ABA referrals for ASD diagnosis need to coordinate PA workflow with ABA providers. Specialty referrals (cardiology, GI, neurology) need PA management.
Top pediatrics billing markets by NPPES org count.
State-level RCM guides for the largest pediatrics billing markets in the U.S.