Neurology Billing Services in Maryland

Maryland's neurology practices face unique billing challenges shaped by CareFirst BlueCross BlueShield's commercial rules, HealthChoice requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both MD payer rules and neurology coding complexity.

AAPC Certified
MD Payer Expert
Neurology Specialists
2.49% Rate
22,000+MD Physicians
2.49%Starting Rate
5Medicaid MCOs
98%+Clean Claim Rate

Why Maryland Neurology Practices Need Specialized Billing

Maryland's healthcare market includes 22,000+ physicians, and neurology practices here face a payer market dominated by CareFirst BlueCross BlueShield on the commercial side and HealthChoice on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect neurology procedure coverage and medical necessity requirements. Generic billing teams without MD 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 Maryland's specific payer rules, authorization requirements, and 5 HealthChoice 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 Baltimore to Bethesda and across Maryland.

Top CPT Codes for Neurology in Maryland

Our MD coders handle these neurology codes daily, applying Novitas Solutions Medicare rules and CareFirst BlueCross BlueShield commercial policies to each claim.

Code
Description
95816
EEG
95907
NCS
95886
EMG
96365
Infusion

Maryland Payer Challenges for Neurology

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

CareFirst BlueCross BlueShield Neurology Claims

CareFirst BlueCross BlueShield processes the largest share of Maryland commercial neurology claims. We know their MD 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.

HealthChoice Neurology Billing

HealthChoice routes neurology patients through 5 managed care plans: CareFirst Community, Aetna Better Health, Molina, and 2 more. Each MCO has its own neurology authorization and billing rules that we manage.

Medicare (Novitas Solutions) Neurology Coverage

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

Denial Prevention for Maryland Neurology

Common neurology denials in Maryland 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 MD payer-specific documentation when denials occur.

Get Expert Neurology Billing in Maryland

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

98%+ clean claim rate
2.49% starting rate
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What We Handle for Maryland 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

Maryland Neurology Billing Cost Comparison

Hiring an in-house biller with neurology expertise in Maryland costs $42K-$55K 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 MD payer specialists for a fraction of that cost.

$42K-$55K

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 MD payers: CareFirst BlueCross BlueShield, Aetna, Cigna, UHC, Kaiser, HealthChoice (including CareFirst Community, Aetna Better Health, Molina), and Medicare through Novitas Solutions. If a payer accepts neurology patients in Maryland, we submit and follow-up on claims with them.
The most frequent neurology denials we see from MD 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 MD payer-specific rules to every claim.
HealthChoice routes neurology patients through 5 managed care plans: CareFirst Community, Aetna Better Health, Molina, Priority Partners, UHC. 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 MD neurology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your neurology workflows, and start submitting claims to CareFirst BlueCross BlueShield, HealthChoice, Medicare, and all your MD payers with no downtime.

Fix Your Maryland Neurology Billing

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