Who We Are We are Prime Medical Billing Solutions, LLC, a results-driven medical billing and revenue cycle partner headquartered in Atlanta, Georgia. Since about 2015, we have operated with the belief that true value lies in partnering, rather than merely contracting, with providers to ensure personalized attention and peak revenue performance. Founded by seasoned billing professionals with 20+ years of combined expert experience, our home office in Atlanta supports both individual practices and larger provider groups. Our team is passionate about maximizing reimbursements and simplifying the billing journey step by step. What Services We Offer We provide a comprehensive suite of services designed to optimize every phase of the revenue cycle: Claims processing & billing management, including electronic, UB‑04, and HCFA‑1500 formats Accounts receivable and collections, focusing on paid-to...
Geriatric Medical Billing Services
Geriatric care is Medicare-heavy and full of care-management codes most practices under-bill. Specialist billers capture annual wellness visits, chronic care management and facility visits.
- Annual wellness visits and advance care planning billed correctly
- Chronic and principal care management time tracking
- Nursing facility and home visits with correct place of service
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Why geriatric practices need specialized billing
Older patients usually have multiple chronic conditions and see several clinicians. Medicare pays for the coordination work this requires through care-management services, chronic care management, principal care management, transitional care and advance care planning, but only when consent, time and care plans are documented correctly.
Geriatric practices also bill annual wellness visits with their own requirements, cognitive assessments, visits in nursing facilities and assisted living, and home visits. Each has specific codes, place-of-service rules and frequency limits that Medicare enforces strictly.
Because most patients have Medicare plus a supplemental or Medicare Advantage plan, coordination of benefits and secondary claims are critical. A geriatric billing partner tracks care-management minutes each month, verifies eligibility for preventive services and makes sure secondary claims go out automatically.
Common geriatrics billing challenges
Unbilled care-management time
Practices provide coordination work every day but miss CCM/PCM billing without monthly time tracking.
Annual wellness visit rules
AWVs differ from physicals and have frequency limits; mixing them up leads to denials and patient bills.
Facility place-of-service accuracy
Nursing facility, assisted living and home visits each require different code families and POS values.
Medicare Advantage authorizations
MA plans often require referrals or authorizations that traditional Medicare does not.
Secondary and supplemental claims
Crossover claims fail silently when coordination of benefits is not maintained.
Cognitive and ACP documentation
Cognitive assessment and advance care planning require specific elements to be billable.
What a geriatrics billing partner should handle
- Medicare and Medicare Advantage eligibility checks
- AWV, IPPE and preventive service coding
- CCM, PCM and TCM time tracking and billing
- Advance care planning and cognitive assessment billing
- Nursing facility and home visit coding
- Crossover and secondary claim follow-up
- Hospice and home health certification billing support
- Denial management and appeals
- Patient and family billing support
- Monthly care-management revenue reports
Key codes in geriatrics billing
| Code(s) | What it covers |
|---|---|
| G0438 / G0439 | Medicare annual wellness visit, initial and subsequent. |
| 99490 / 99439 | Chronic care management, first 20 minutes and each additional 20 minutes per month. |
| 99487 / 99489 | Complex chronic care management, first 60 minutes and each additional 30 minutes. |
| 99495 / 99496 | Transitional care management after discharge, moderate / high complexity. |
| 99497 / 99498 | Advance care planning, first 30 minutes and each additional 30 minutes. |
| 99483 | Cognitive assessment and care plan services. |
| 99304–99310 | Initial and subsequent nursing facility care. |
Code examples are for orientation only. Always code from the current CPT®, HCPCS and ICD-10-CM code sets and payer policies.
Consent and care plans first
Care-management services require documented patient consent, a comprehensive care plan shared with the patient, and time logs for each month. Billing partners should verify these before claims go out to protect you in Medicare audits.
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Tell us your specialty, monthly claim volume, EHR and the problems you want fixed, denials, slow A/R or staffing gaps.
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We review a sample of your claims and aging report to show where revenue is leaking and what a specialist could recover.
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How much does geriatrics billing cost?
Most billing companies charge a percentage of what they actually collect, so their incentive matches yours. Complex specialties sit at the higher end of the range because of prior authorizations, modifiers and appeal work.
Most common. You pay only on money collected.
Predictable for high-volume, low-complexity claims.
Dedicated billers working inside your systems.
Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.
Geriatrics billing FAQs
CCM pays practices for non-face-to-face care coordination for patients with two or more chronic conditions, using codes such as 99490 when at least 20 minutes are provided in a calendar month.
No. The AWV focuses on a personalized prevention plan and health risk assessment. Routine physicals are not covered by Medicare.
Medicare now allows TCM and CCM in the same period when time is not counted twice and requirements for each are met.
Yes, using nursing facility codes with the correct place of service, plus assisted living and home visit codes.
By keeping coordination-of-benefits information current and following up on any crossover claims that do not process automatically.
Usually about 4% to 7% of collections.
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