Dermatology Billing Services in New York

New York's dermatology practices face unique billing challenges shaped by Empire BlueCross BlueShield's commercial rules, NY Medicaid Managed Care requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both NY payer rules and dermatology coding complexity.

AAPC Certified
NY Payer Expert
Dermatology Specialists
2.49% Rate
90,000+NY Physicians
2.49%Starting Rate
6Medicaid MCOs
98%+Clean Claim Rate

Why New York Dermatology Practices Need Specialized Billing

New York's healthcare market includes 90,000+ physicians, and dermatology practices here face a payer market dominated by Empire BlueCross BlueShield on the commercial side and NY Medicaid Managed Care on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect dermatology procedure coverage and medical necessity requirements. Generic billing teams without NY specific knowledge leave revenue on the table.

Dermatology billing itself is complex. Dermatology practices perform dozens of procedures daily alongside office visits. Biopsy coding changed significantly with the 11102-11104 code series, lesion destruction has count-based coding (17000 for first, 17003 for 2-14), and Mohs surgery (17311-17315) has its own complex coding structure. Practices that don't code these correctly lose significant revenue. When you combine this coding complexity with New York's specific payer rules, authorization requirements, and 6 NY Medicaid Managed Care 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 dermatology practices from New York City to Albany and across New York.

Top CPT Codes for Dermatology in New York

Our NY coders handle these dermatology codes daily, applying Novitas Solutions Medicare rules and Empire BlueCross BlueShield commercial policies to each claim.

Code
Description
11102
Tangential biopsy (shave)
11104
Punch biopsy
17000
Destruction of first lesion (cryotherapy)
17003
Destruction of additional lesions (2-14)
17311
Mohs surgery, first stage, head/neck
11600-11606
Excision of malignant lesion (by size)
96910-96922
Phototherapy (UV-B, PUVA)
96401-96402
Chemotherapy injection (biologics)

New York Payer Challenges for Dermatology

Every NY payer has specific rules for dermatology claims. Here's how we navigate them.

Empire BlueCross BlueShield Dermatology Claims

Empire BlueCross BlueShield processes the largest share of New York commercial dermatology claims. We know their NY specific fee schedules, prior authorization requirements for dermatology procedures, and their appeal timelines when claims are denied. Tangential (11102), punch (11104), and incisional (11106) have different RVUs. Wrong selection costs revenue.

NY Medicaid Managed Care Dermatology Billing

NY Medicaid Managed Care routes dermatology patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, and 3 more. Each MCO has its own dermatology authorization and billing rules that we manage.

Medicare (Novitas Solutions) Dermatology Coverage

Novitas Solutions processes Medicare dermatology claims in New York with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around lesion count coding to prevent medical necessity denials.

Denial Prevention for New York Dermatology

Common dermatology denials in New York include wrong biopsy technique code selected and lesion count not documented for destruction codes. Our team catches these issues before submission and appeals aggressively with NY payer-specific documentation when denials occur.

Get Expert Dermatology Billing in New York

Free billing assessment for your NY dermatology practice. See where revenue is leaking.

98%+ clean claim rate
2.49% starting rate
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What We Handle for New York Dermatology Practices

Biopsy coding (tangential, punch, incisional)
Lesion destruction with count-based coding
Mohs micrographic surgery billing
Excision coding with size documentation
Phototherapy and biologic administration
Same-day E/M + procedure optimization
Medical necessity documentation support
Pathology code coordination

New York Dermatology Billing Cost Comparison

Hiring an in-house biller with dermatology expertise in New York costs $45K-$62K 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 dermatology coders and NY payer specialists for a fraction of that cost.

$45K-$62K

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 NY payers: Empire BlueCross BlueShield, Aetna, Cigna, UHC, EmblemHealth, Oxford, NY Medicaid Managed Care (including Fidelis Care, Healthfirst, MetroPlus), and Medicare through Novitas Solutions. If a payer accepts dermatology patients in New York, we submit and follow-up on claims with them.
The most frequent dermatology denials we see from NY payers include wrong biopsy technique code selected, lesion count not documented for destruction codes, mohs stage/block documentation insufficient. Our team catches these before submission by applying both dermatology coding expertise and NY payer-specific rules to every claim.
NY Medicaid Managed Care routes dermatology patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, Molina, MVP, United. Each MCO has its own dermatology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your dermatology practice gets paid correctly.
Most NY dermatology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your dermatology workflows, and start submitting claims to Empire BlueCross BlueShield, NY Medicaid Managed Care, Medicare, and all your NY payers with no downtime.

Fix Your New York Dermatology Billing

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