Neurology Billing Services in California

California's neurology practices face unique billing challenges shaped by Blue Shield of California / Anthem's commercial rules, Medi-Cal requirements, and Noridian Medicare policies. Our AAPC-certified coders specialize in both CA payer rules and neurology coding complexity.

AAPC Certified
CA Payer Expert
Neurology Specialists
2.49% Rate
110,000+CA Physicians
2.49%Starting Rate
5Medicaid MCOs
98%+Clean Claim Rate

Why California Neurology Practices Need Specialized Billing

California's healthcare market includes 110,000+ physicians, and neurology practices here face a payer market dominated by Blue Shield of California / Anthem on the commercial side and Medi-Cal on the public payer side. Medicare claims are processed through Noridian, which applies its own Local Coverage Determinations that directly affect neurology procedure coverage and medical necessity requirements. Generic billing teams without CA specific knowledge leave revenue on the table.

Neurology billing itself is complex. Neurology diagnostic testing codes have professional and technical components, time-based elements, and study-specific documentation requirements. EMG/NCS (95907-95913, 95885-95886) requires documenting specific nerves tested. EEG (95816-95822) has awake, sleep, and long-term monitoring variants. When you combine this coding complexity with California's specific payer rules, authorization requirements, and 5 Medi-Cal managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving neurology practices from Los Angeles to Oakland and across California.

Top CPT Codes for Neurology in California

Our CA coders handle these neurology codes daily, applying Noridian Medicare rules and Blue Shield of California / Anthem commercial policies to each claim.

Code
Description
95816
EEG
95907
NCS
95886
EMG
96365
Infusion

California Payer Challenges for Neurology

Every CA payer has specific rules for neurology claims. Here's how we navigate them.

Blue Shield of California / Anthem Neurology Claims

Blue Shield of California / Anthem processes the largest share of California commercial neurology claims. We know their CA specific fee schedules, prior authorization requirements for neurology procedures, and their appeal timelines when claims are denied. Nerve conduction and needle EMG have separate code families that must be coordinated.

Medi-Cal Neurology Billing

Medi-Cal routes neurology patients through 5 managed care plans: LA Care, Health Net, Molina, and 2 more. Each MCO has its own neurology authorization and billing rules that we manage.

Medicare (Noridian) Neurology Coverage

Noridian processes Medicare neurology claims in California with its own Local Coverage Determinations. We navigate Noridian's policies around eeg variant selection to prevent medical necessity denials.

Denial Prevention for California Neurology

Common neurology denials in California include nerve conduction and needle emg have separate code families that must be coordinated and routine, extended, ambulatory, and video eeg each have different codes and documentation. Our team catches these issues before submission and appeals aggressively with CA payer-specific documentation when denials occur.

Get Expert Neurology Billing in California

Free billing assessment for your CA neurology practice. See where revenue is leaking.

98%+ clean claim rate
2.49% starting rate
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What We Handle for California Neurology Practices

EEG coding (routine, extended, video, ambulatory)
EMG and nerve conduction study billing
Sleep study billing (PSG and HST)
Neurology infusion therapy coding
Botox injection billing (migraine, spasticity)
Prior auth for advanced neuro testing

California Neurology Billing Cost Comparison

Hiring an in-house biller with neurology expertise in California costs $50K-$70K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified neurology coders and CA payer specialists for a fraction of that cost.

$50K-$70K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

Frequently Asked Questions

All major CA payers: Blue Shield of California / Anthem, Kaiser, Health Net, Aetna, Cigna, UHC, Medi-Cal (including LA Care, Health Net, Molina), and Medicare through Noridian. If a payer accepts neurology patients in California, we submit and follow-up on claims with them.
The most frequent neurology denials we see from CA payers include nerve conduction and needle emg have separate code families that must be coordinated, routine, extended, ambulatory, and video eeg each have different codes and documentation, neurology infusions (biologics, ivig) require sequential administration coding. Our team catches these before submission by applying both neurology coding expertise and CA payer-specific rules to every claim.
Medi-Cal routes neurology patients through 5 managed care plans: LA Care, Health Net, Molina, Anthem, CalOptima. Each MCO has its own neurology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your neurology practice gets paid correctly.
Most CA neurology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your neurology workflows, and start submitting claims to Blue Shield of California / Anthem, Medi-Cal, Medicare, and all your CA payers with no downtime.

Fix Your California Neurology Billing

Call 888-701-6090 for a free billing assessment specific to your CA neurology practice. We'll show you where revenue is leaking and how to fix it.