Medical practices are almost as diverse as people in regards to the arrangements and agreements that exist between physicians and facilities. The existence of different fiscal arrangements requires that medical entities bill their charges based on the specific level of service that the entity is providing to the patient.  CMS has created billing rules to accommodate these different scopes of service by standardizing medical billing for the entire insurance industry. When a biller understands the definition of the CPT-4 codes, and modifiers, they can then bill according to CMS’s requirements. This leads to fewer denials and better payment history.

Read more on our biller's blog.