Neurology Billing Services in New York
New York's neurology 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 neurology coding complexity.
Why New York Neurology Practices Need Specialized Billing
New York's healthcare market includes 90,000+ physicians, and neurology 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 neurology procedure coverage and medical necessity requirements. Generic billing teams without NY 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 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 neurology practices from New York City to Albany and across New York.
Top CPT Codes for Neurology in New York
Our NY coders handle these neurology codes daily, applying Novitas Solutions Medicare rules and Empire BlueCross BlueShield commercial policies to each claim.
New York Payer Challenges for Neurology
Every NY payer has specific rules for neurology claims. Here's how we navigate them.
Empire BlueCross BlueShield Neurology Claims
Empire BlueCross BlueShield processes the largest share of New York commercial neurology claims. We know their NY 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.
NY Medicaid Managed Care Neurology Billing
NY Medicaid Managed Care routes neurology patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, and 3 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 New York with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around eeg variant selection to prevent medical necessity denials.
Denial Prevention for New York Neurology
Common neurology denials in New York 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 NY payer-specific documentation when denials occur.
Get Expert Neurology Billing in New York
Free billing assessment for your NY neurology practice. See where revenue is leaking.
What We Handle for New York Neurology Practices
New York Neurology Billing Cost Comparison
Hiring an in-house biller with neurology 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 neurology 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 neurology billing resources.
Frequently Asked Questions
Fix Your New York Neurology Billing
Call 888-701-6090 for a free billing assessment specific to your NY neurology practice. We'll show you where revenue is leaking and how to fix it.