SpecialtiesPrimary & acute care
How we see geriatrics billing.
Reviewed by the VisMed primary & acute care billing team
A geriatric panel is almost entirely Medicare and Medicare Advantage, with patients who need more than a visit: care coordination between visits, transitions after every hospital stay, and conversations about goals of care. Medicare pays for all of that, through specific codes with specific requirements, and most practices bill only the visit.
The reason is not ignorance. The programs need consent, time logs, care plans and outreach that the clinical team does not have time to run. So the practice does the work informally, for free, and bills the office visit.
Our position is that a geriatrics practice should be paid for the coordination it already does. VisMed supplies the staff and the process for care management, transitional care and wellness visits, and our coders handle the setting-specific rules for nursing facility, assisted living and home visits, which is where the coding errors cluster.
Where geriatrics practices lose money
The patterns we find in the aging and denial history before anything else changes.
Care management done but not billed
Chronic care management, principal care management and complex CCM pay monthly for coordination the practice already provides. Without consent on file and time logged, none of it is billable.Advance care planning unrecorded
Goals-of-care conversations are billable by time, with no copay when done with the AWV. Physicians have them constantly and rarely document minutes.Place-of-service errors on facility visits
Nursing facility, assisted living and home visits each have their own code family and place-of-service. A facility visit billed as an office visit is denied or paid at the wrong rate.Transitional care missed after discharge
The two-business-day contact is the step that fails. Without it, the well-paid TCM visit becomes an ordinary follow-up.Advantage plan authorizations and referrals
Each plan keeps its own list, and geriatric patients switch plans at open enrollment. Last year’s rules produce this year’s denials.
What we do differently for geriatrics
Specialty-matched coders and a denials specialist, working inside your own system.
Our care managers do the care-management work
Consent, monthly outreach, time logs and care-plan upkeep are handled by VisMed care managers, working in your system, under your physicians’ supervision.We code by setting
Our coders bill the visit by where it happened, with the nursing facility, domiciliary and home visit families and their documentation rules applied correctly.We work discharge notifications daily
ADT or HIE feeds, or the hospital’s daily list, drive our TCM contact and follow-up scheduling.We re-verify the panel at open enrollment
Every January we re-verify the whole panel so plan changes are caught before the first claim of the year, not by its denial.
What we bill
The procedure and code families your account team already works in.
Geriatrics billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
Who supervises VisMed’s care-management staff?
Your physicians. Medicare requires general supervision, and VisMed’s care managers work under it, in your system, following care plans your clinicians approve. The revenue is yours; the labor is ours.
Can VisMed bill visits at nursing homes and assisted living facilities?
Each setting has its own code family and place-of-service, and VisMed also manages the consolidated-billing rules that decide what the facility bills and what you bill during a Part A stay.
How does VisMed catch the transitional care window?
With a daily discharge list from your hospital feeds or the facilities you round at. We make and document the interactive contact within two business days and schedule the visit inside the seven- or fourteen-day window the code requires.
Is advance care planning really billable?
Yes, by time, and without a copay when performed as part of the Annual Wellness Visit. It needs the minutes and the voluntary nature of the conversation documented. VisMed gives physicians a short template so it takes ten seconds.
How does VisMed handle Medicare Advantage plan changes each year?
We re-verify every patient on the panel each January, load the new plan’s authorization and referral rules before the first visit of the year, and update the care-management enrollments that move with the patient.
Also in primary & acute care
Family medicine
Preventive, chronic and acute visits under one cycle.
Internal medicine
E/M leveling, chronic-care codes and complex payers.
Pediatrics
Well-child schedules, vaccines and Medicaid rules.
General practice
Broad code sets, kept accurate at volume.
Urgent care
Walk-in registration, S-codes and fast turnaround.
Emergency medicine
Facility and professional claims, critical-care time.
Osteopathic medicine
OMT with E/M on the same visit, modifier-correct.
Sleep medicine
Studies, home testing and DME crossover.
Sports medicine
Injections, imaging and therapy bundles.
All specialties
The full list, in six groups
See where your geriatrics practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
or write directly hello@vis.med