Can you recover aging unpaid neurology claims?

Yes. We audit your accounts receivable aging report, correct coding or documentation issues, and resubmit eligible claims with supporting appeals to recover unpaid revenue.

Neurology Billing Services in New Mexico | EZE Medical Billing

Neurology Billing Services in New Mexico – Accurate Coding for Complex Neurological Care

Neurology is one of the most coding-intensive specialties in medicine. Neurologists use a wider mix of diagnostic procedures, chronic disease management codes, and time-based billing rules than almost any other specialty. One wrong code, a missing modifier, or an uncaptured diagnostic test can mean the difference between a paid claim and a denial — or worse, an underpayment that goes unnoticed for months.
At EZE Medical Billing Services, we provide neurology billing services built specifically around the way neurology practices actually work. We handle everything from routine office visits and EEG billing to complex epilepsy monitoring and neuromuscular disorder coding — for neurologists, neurology group practices, and hospital-affiliated neurology departments across New Mexico.
If your neurology practice is dealing with rising denial rates, slow payer reimbursements, or a billing team that isn’t fully comfortable with neurology-specific codes, we are the right partner for you.

What We Deliver for Neurology Practices

Clean Claim Rate

Hrs

Claim Submission

Denied Claim Recovery

What Makes Neurology Billing Different From General Medical Billing

Neurology billing isn’t just harder than general medical billing — it’s different in kind. The code set is larger, the documentation requirements are stricter, and the diagnostic procedures involved have billing rules that catch most general billers off guard. Here’s what makes it genuinely complex:

Time-Based E&M Billing

Since 2021, Medicare and most commercial payers have allowed neurologists to bill office visits based on total time spent — including documentation time — rather than medical decision making alone. This opened up significant revenue opportunity for cognitive-heavy specialties like neurology, but capturing it correctly requires proper time documentation in the chart and a biller who knows how to apply the time-based rules. Practices that aren't billing time-based E&M are routinely undercoding.

Diagnostic Procedure Billing — EEG, EMG, and Nerve Conduction Studies

Neurology has its own set of diagnostic procedures that come with their own CPT codes, technical and professional component rules, and payer-specific coverage policies. EEG billing (routine, ambulatory, long-term monitoring), EMG and nerve conduction studies, evoked potentials, and polysomnography all require precise coding that most general billers aren't trained on. One category error — billing costs real money on every affected claim.

Chronic Disease Management and Care Plan Coding

A large portion of neurology patients have chronic conditions — epilepsy, Parkinson's disease, multiple sclerosis, ALS, migraine, dementia, and neuropathy. These patients are seen repeatedly, often across multiple care settings. Chronic Care Management (CCM) codes and complex chronic care codes represent significant billable revenue that most neurology practices either don't capture at all or capture incorrectly because their billing team doesn't know how to apply them.

Prior Authorization for High-Cost Treatments

Neurology treatments have expanded significantly in recent years. Botulinum toxin injections for migraine and spasticity, multiple sclerosis infusion therapies, and newer epilepsy medications all typically require prior authorization — and each payer has different documentation requirements and approval timelines. A missed or expired authorization means a full claim denial on a high-value service.

Incident-To Billing for Mid-Level Providers

Many neurology practices use nurse practitioners or physician assistants to handle follow-up visits. When billed correctly under the supervising physician (incident-to billing), these visits reimburse at 100% of the physician rate. When billed under the mid-level provider's own NPI, they pay at 85%. The difference matters, and the rules around incident-to billing are easy to get wrong — particularly in group practice settings.

Overlapping and Bundled Procedure Codes

Certain neurology procedures — like performing an EMG and nerve conduction study on the same patient on the same day — have complex bundling rules that vary by payer. Some payers bundle these automatically if billed together; others require specific modifiers to indicate they're separate, distinct services. Without someone tracking these rules, practices either get bundled down or denied outright.

Neurology CPT Codes We Handle

CDT Code	Procedure / Service	Frequent Billing Pitfall
99202–99215	Office/Outpatient E&M — New and Established	Undercoding on time-based visits; wrong level for MDM
95816 / 95819	Routine EEG — Awake / Awake and Drowsy	Missing tech vs. professional component split (Mod 26 / TC)
95822	EEG — Sleep Only	Billed without sleep documentation in chart
95951 / 95953	Long-Term EEG / Ambulatory EEG Monitoring	Incorrect per-day billing; missing physician review code
95861–95870	Needle EMG — Extremities and Paraspinal	Bundled incorrectly with NCS; wrong number of muscles
95907–95913	Nerve Conduction Studies — Motor and Sensory	Payer-specific bundling not applied; missing H/J modifiers
95925–95930	Evoked Potentials — Somatosensory / Visual	Global billed when only professional component performed
64615 + J0585	Botox — Chronic Migraine Injection + Drug Supply	Drug supply code missing; prior auth not verified
95970–95976	Deep Brain Stimulator Programming	Billed per session without time documentation
99490 / 99487	Chronic Care Management — Standard / Complex	Not billed at all; time tracking documentation missing
95808 / 95810	Polysomnography — Sleep Study	Sleep technician credential not verified; missing channels
99213–99215	Established Patient Neurology Follow-Up	Time-based billing not applied; undercoded by 1–2 levels

Our Neurology Billing Services

Insurance Eligibility and Benefits Verification

Before every patient visit or procedure, we confirm active insurance coverage, deductible and co-pay status, specialist visit limits, and whether the planned service requires a referral or prior authorization. This one step prevents a significant percentage of claim rejections that happen simply because coverage wasn't checked before the service was rendered.

Neurology-Specific CPT Coding

Our billing team handles the full range of neurology CPT codes — from E&M office visits at every level of complexity to the complete set of neurological diagnostic procedure codes. We apply the correct codes, modifiers, and time-based billing rules based on what's documented in the chart. We do not generalize — if the note says 57 minutes of total time on a complex patient, we code a 99215 with the appropriate time documentation, not a 99213 out of habit.

EEG Billing

We handle the full range of EEG billing including routine EEG (CPT 95816, 95819), sleep-deprived EEG (95822), ambulatory EEG monitoring (95953), and long-term EEG monitoring (95951, 95956, 95957). We apply the correct technical vs. professional component modifiers based on your practice setup — whether you own your EEG equipment, rent it, or contract with a hospital for the technical component.

EMG and Nerve Conduction Study Billing

Electromyography (EMG) and nerve conduction studies (NCS) are high-value services that are frequently miscoded. We correctly apply needle EMG codes (95861–95872), nerve conduction codes (95907–95913), and the payer-specific bundling rules that govern what can be billed together in a single encounter. We also handle the H and J modifiers required by certain payers for NCS claims.

Evoked Potential Studies

Visual evoked potentials (CPT 95930), brainstem auditory evoked potentials (95925, 95926), and somatosensory evoked potentials (95925, 95927) are commonly performed in neurology but infrequently billed correctly. We know the coverage indications, documentation requirements, and technical vs. professional split billing rules for each type.

Botulinum Toxin (Botox) Injection Billing for Neurology

Neurological Botox injections for chronic migraine (CPT 64615, J0585), cervical dystonia, and spasticity are high-revenue services with strict prior authorization and dosage documentation requirements. We handle the prior authorization process, verify medical necessity documentation, bill the injection procedure code alongside the appropriate drug administration and drug supply codes, and manage denials when payers reject based on dosage or diagnosis.

Chronic Care Management (CCM) and Transitional Care Billing

Neurology practices with significant chronic disease patient populations — epilepsy, MS, Parkinson's, dementia — have substantial CCM billing potential that most practices don't capture. We identify eligible patients, track monthly care coordination time, and bill CPT 99490, 99491, 99487, and 99489 correctly. For patients transitioning from hospital or skilled nursing facility, we also handle TCM codes 99495 and 99496.

Monthly Neurology Revenue Reporting

Every month you receive a performance report showing collections by payer and procedure category, denial rates broken down by reason code, AR aging by payer, and month-over-month revenue trends. This data gives you a real view of your practice's financial performance — not just a total collections number with no context.

Neurology Practices We Serve in New Mexico

We work with neurology providers of all types and sizes across New Mexico:

General neurology practices — solo neurologists and group practices
Epilepsy centers and long-term EEG monitoring units
Multiple sclerosis specialty clinics
Movement disorder programs — Parkinson’s disease, dystonia, tremor
Neuromuscular disease clinics — ALS, myasthenia gravis, neuropathy
Headache and migraine specialty practices
Memory and cognitive disorders clinics — dementia, Alzheimer’s
Pediatric neurology practices
Sleep medicine practices with neurological focus
Hospital-based and academic neurology departments
Telehealth neurology providers serving rural New Mexico

We serve neurology practices across Albuquerque, Santa Fe, Rio Rancho, Las Cruces, Roswell, Farmington, and throughout the rest of New Mexico — including rural communities where neurological care is limited and proper billing is essential to keeping practices financially viable.

How We Get Your Practice Onboarded

Switching billing companies does not have to be disruptive. Here’s how we do it:

We look at your current payer mix, denial patterns, AR aging, and any recurring coding issues to identify where your revenue is leaking before we start.Free Practice Review —
We document how your practice records encounter data, manages authorizations, and tracks diagnostic procedure results so our workflow fits into yours — not the other way around.Workflow Mapping —
We connect to your EHR or practice management system. For neurology we commonly work with Epic, Athenahealth, AdvancedMD, NextGen, Neuropoint, and similar platforms.System Connection —
If you have a backlog of aging claims, we start working them immediately. Many practices recover meaningful revenue during the onboarding period alone.AR Cleanup —
New claims start processing within the agreed timeline. You will have a dedicated billing contact who knows your practice, not a general support queue.Go Live —
We review performance data with you each month, flag any emerging payer issues, and adjust the process as your practice changes.

Frequently Asked Questions — Neurology Billing in New Mexico

Do you handle EEG and EMG billing separately from general neurology office visits?

Yes. EEG and EMG billing are managed as their own workflow within our neurology billing process. We apply the correct procedure codes, technical and professional component splits, and payer-specific bundling rules for each diagnostic category. These are not billed the same way as office visits, and we treat them accordingly.

Can you help our practice start billing for Chronic Care Management?

Yes. CCM is one of the most underutilized revenue sources in neurology. We review your patient panel to identify eligible chronic disease patients, set up a time-tracking process for monthly care coordination, and handle all the billing using the appropriate CCM codes. Most practices see meaningful new revenue within the first billing cycle.

How do you handle prior authorization for MS infusion therapy and Botox?

We submit prior authorization requests with the supporting clinical documentation required by each payer, track approval status, and flag any cases where the authorization may expire or require renewal before treatment is delivered. For initial denials on high-cost neurological treatments, we file peer-to-peer review requests or formal clinical appeals on your behalf.

Do you work with New Mexico Medicaid for neurology billing?

Yes. New Mexico Medicaid (Centennial Care) has its own coverage policies and prior authorization requirements for neurology services — including specific rules for EEG, EMG, and certain neurological medications. We are experienced in NM Medicaid neurology billing and stay current with policy changes so your claims remain compliant.

What EHR systems do you work with for neurology practices?

We work with Epic, Athenahealth, AdvancedMD, NextGen, Neuropoint, Kareo, and other common neurology practice management platforms. We confirm compatibility during the initial consultation and manage the integration setup before onboarding begins.

How much does outsourcing neurology billing cost?

We charge a percentage of monthly collections — you pay based on what we collect for your practice. There are no flat fees, no setup costs, and no long-term contracts. Contact us for a quote based on your patient volume, payer mix, and the range of services your practice performs.

We have a lot of aging unpaid claims. Can you recover them?

This is one of the first things we address during onboarding. We audit your AR aging report, identify claims still within the timely filing window, correct any coding or documentation issues, and resubmit with supporting appeals where needed. Neurology practices often have significant recoverable revenue sitting in aging AR because the claims feel too complex to deal with — we deal with them.