DME Billing Services in New York
New York's dme 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 dme coding complexity.
Why New York DME Practices Need Specialized Billing
New York's healthcare market includes 90,000+ physicians, and dme 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 dme procedure coverage and medical necessity requirements. Generic billing teams without NY specific knowledge leave revenue on the table.
DME billing itself is complex. DME billing uses HCPCS Level II codes with CMN documentation, proof of delivery requirements, and rental/purchase rules that differ by equipment category. 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 dme practices from New York City to Albany and across New York.
Top CPT Codes for DME in New York
Our NY coders handle these dme codes daily, applying Novitas Solutions Medicare rules and Empire BlueCross BlueShield commercial policies to each claim.
New York Payer Challenges for DME
Every NY payer has specific rules for dme claims. Here's how we navigate them.
Empire BlueCross BlueShield DME Claims
Empire BlueCross BlueShield processes the largest share of New York commercial dme claims. We know their NY specific fee schedules, prior authorization requirements for dme procedures, and their appeal timelines when claims are denied. Incomplete CMN forms are the #1 DME denial reason.
NY Medicaid Managed Care DME Billing
NY Medicaid Managed Care routes dme patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, and 3 more. Each MCO has its own dme authorization and billing rules that we manage.
Medicare (Novitas Solutions) DME Coverage
Novitas Solutions processes Medicare dme claims in New York with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around rental vs purchase to prevent medical necessity denials.
Denial Prevention for New York DME
Common dme denials in New York include incomplete cmn forms are the #1 dme denial reason and capped rental, inexpensive/routine, and frequent service categories each have rules. Our team catches these issues before submission and appeals aggressively with NY payer-specific documentation when denials occur.
Get Expert DME Billing in New York
Free billing assessment for your NY dme practice. See where revenue is leaking.
What We Handle for New York DME Practices
New York DME Billing Cost Comparison
Hiring an in-house biller with dme 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 dme 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
Related Pages
Explore our New York and dme billing resources.
Frequently Asked Questions
Fix Your New York DME Billing
Call 888-701-6090 for a free billing assessment specific to your NY dme practice. We'll show you where revenue is leaking and how to fix it.