- Critical Care Medical Billing Services
Critical Care Medical Billing Services
Critical care billing is one of the most scrutinized specialties in healthcare. One missing time stamp, one incorrectly bundled procedure, or one wrong critical care code—and you’re losing $40K-$90K monthly.
Neo MD fixes that with critical care-certified coders who understand the 30-minute threshold, procedure bundling rules, and how to document time-based critical care services without denials.
97-99%
First-Pass Claim
+28%
Avg Revenue Increase
90
Days to Results
- Practice Revenue Health Audit
Is Your Pathology Critical Care
Bleeding Revenue?
Visible Revenue Bleed
Immediate Impact
Critical Care Time Claims Denied
Time documentation is insufficient for 99291/99292
Ventilator Management Claims Rejected
Bundling errors with critical care codes
Central Line Placement Claims Denied
Missing ultrasound guidance documentation
Prolonged Critical Care Claims Delayed
Add-on code 99292 documentation gaps
Procedures During Critical Care Bundled
When separately billable procedures should've been coded
Same-Day Admission Violations
Wrong code selection for admission with critical care
Invisible Losses
According to SCCM and MGMA critical care benchmarking data, practices lose 18%–25% of revenue due to:
Critical Care Time Tracking
Insufficient documentation of 30+ minutes
Ventilator Management Billing
Not coding 94002-94005 separately
Central Line Procedures
Missing ultrasound guidance billing
Prolonged Service Add-Ons
Not billing 99292 for additional time
Procedure Documentation
Bundling separately billable services
Admission Day Coding
Wrong hospital admission code selection
Transport Critical Care
Missing 99466-99467 for transfers
Modifier 25 Application
Not separating E/M from procedures
"You didn't train for 10+ years to fight with insurance companies. But right now, coding errors cost more than an intensivist's salary."
- Industry Problem
Why General Medical Billing Companies Fail Critical Care Practices
Critical care billing requires specialty expertise that general billers don’t have.
Time documentation chaos
Can't track and document critical care time properly
Ventilator coding blindspot
Don't bill management codes separately
Central line confusion
Miss ultrasound guidance billing (76937)
Prolonged service miss
Don't capture add-on codes for extended time
Procedure bundling errors
Bundle services that bill separately from critical care
Medical necessity gaps
Can't document critical care criteria
Admission day mistakes
Use the wrong codes when critical care is required on admission day
Transport coding blindspot
Miss interfacility transport critical care
Result: 15%–22% denial rates, 45-60 day payment cycles, and constant staff time wasted on resubmissions.
- The NEO MD Difference
The Neo MD Critical Care Advantage
Ultra-Specialized Billing Built for ICU Complexity
Critical Care-Certified Coding Teams
- Expert knowledge of critical care time requirements (30-minute threshold, incremental billing)
- Understanding of critical illness/injury definitions
- Correct procedure bundling vs separate billing determination
- Proper documentation of time spent on critical care activities
- ED critical care vs ICU critical care distinction
- Pediatric vs adult critical care code selection
→ 97-99% first-pass acceptance rate vs 60-72% industry average
Time Documentation Mastery
We ensure proper documentation for:
- Exact start and stop times for critical care
- Total time spent (excluding separately billable procedures)
- Activities performed during critical care time
- Multiple critical care encounters on the same day (when applicable)
- Calculation of additional 30-minute increments (99292)
- Face-to-face vs unit/floor time distinctions
→ Zero time-based denials through precise documentation
Critical Care vs Hospital Care Distinction
Expert determination of when to bill:
- 99291/99292 (critical care services)
- 99221-99223 (initial hospital care)
- 99231-99233 (subsequent hospital care)
- 99291 + 99233 (same day, when appropriate)
- 99238-99239 (discharge day management)
→ Appropriate code selection based on acuity and documentation
Procedure Billing Optimization During Critical Care
We correctly identify procedures that are:
- Bundled into critical care (cannot bill separately)
- Separately billable (endotracheal intubation, central line, chest tube, cardioversion, etc.)
Common separately billable procedures:
- Endotracheal intubation (31500)
- Central venous catheter insertion (36555-36556)
- Arterial line placement (36620)
- Chest tube insertion (32551)
- Cardioversion (92960)
- Temporary pacemaker insertion (33210)
- Lumbar puncture (62270)
- Paracentesis (49082)
- Thoracentesis (32554-32555)
→ $15,000-$35,000 monthly recovery from missed procedures
Critical Care Transport Billing
Expert handling of:
- Interfacility transport (99466-99467)
- Time-based transport billing (first 30-74 minutes, each additional 30 minutes)
- Face-to-face transport attendance
- Critical care during transport
- Proper documentation requirements
→ Complete revenue capture on transport services
Pediatric & Neonatal Critical Care Expertise
Correct coding for:
- Pediatric critical care (99471-99476)
- Neonatal critical care (99468-99469, 99477-99480)
- Age-based code selection
- Weight-based code selection (for neonates)
- Initial vs subsequent day distinctions
→ Specialized knowledge across all age groups
Real-Time Revenue Visibility
- Daily critical care claim tracking
- Weekly time documentation audit
- Monthly financial performance by service location (ICU, ED, floor)
- Quarterly coding accuracy review
→ Complete transparency with critical care-specific metrics
Critical Care Services We Master
Adult Critical Care
- Critical care, first 30-74 minutes (99291)
- Critical care, each additional 30 minutes (99292)
- ED critical care services
- ICU daily critical care
- Multiple critical care encounters same day
Pediatric Critical Care
- Initial pediatric critical care (99471-99472)
- Subsequent pediatric critical care (99475-99476)
- Age-based code selection (28 days through 5 years)
Neonatal Critical Care
- Initial neonatal critical care (99468, 99477)
- Subsequent neonatal critical care (99469, 99478-99480)
- Weight-based code selection
- NICU level-specific services
Critical Care Transport
- Interfacility transport, first 30-74 minutes (99466)
- Interfacility transport, each additional 30 minutes (99467)
- Critical care during transport
- Neonatal/pediatric transport specialty codes
Procedures During Critical Care
- Endotracheal intubation (31500)
- Central venous catheterization (36555-36556, 36568-36569)
- Arterial catheterization (36620)
- Chest tube insertion (32551)
- Cardioversion/defibrillation (92960-92961)
- Temporary pacemaker (33210)
ICU Consultation & Management
- Critical care consultation
- Family conferences during critical care
- Multidisciplinary ICU rounds
- Goals of care discussions
If you provide it in critical care, we bill it correctly—the first time.
Real Results: 8-Critical Care Group (Florida)
“We had no idea how much money we were losing on time documentation alone. Neo MD taught us how to document properly and their billing team captures every procedure, every transport, every additional 30-minute increment. Our revenue increased 32% with the same patient volume.”
— Dr. Robert M., Critical Care Medicine
| Metric | Before NEO MD | After NEO MD (90 Days) |
|---|---|---|
| Denial Rate on Critical Care | 34% | 2.4% |
| Annual Revenue Loss | $720,000 | Eliminated |
| Time Documentation Compliance | Consistently Insufficient | 99%+ Compliant |
| Procedure Billing During Critical Care | Bundled / Not Billed | +$28,000 / month |
| 99292 Add-On Code Capture | Missing | +$18,000 / month |
| ED Critical Care Billing | Underbilled as Regular E/M | Properly Coded |
| Total Revenue Impact | Missed Revenue | $84,000 / month ($1.008M annually) |
Performance Benchmarking: Neo MD vs Industry Standard
| Performance Metric | Industry Average | Neo MD Critical Care |
|---|---|---|
| Clean Claim Rate | 60–72% | 97–99% |
| Denial Rate | 28–40% | 2–5% |
| Time Documentation Accuracy | 58–71% | 98%+ |
| Procedure Capture During Critical Care | 52–68% | 96%+ |
| 99292 Add-On Billing | 44–62% | 94%+ |
| Transport Service Billing | 35–58% | 98%+ |
| Days to Payment | 52–72 days | 28–38 days |
| Collection Rate | 88–91% | 97–99% |
Our Process: Revenue Acceleration in 90 Days
We conduct a comprehensive, critical care–specific analysis that includes reviewing time documentation for 30-minute threshold compliance, auditing critical care versus hospital care code selection, and assessing procedure billing during critical care encounters. Our review also evaluates 99292 add-on code capture, transport service billing accuracy, and distinctions between emergency department and ICU critical care services. In addition, we identify medical necessity documentation gaps that may impact reimbursement. Clients receive a detailed report that clearly outlines revenue leakage by service category, helping pinpoint opportunities for compliance improvement and revenue optimization.
Our implementation process ensures zero disruption to ICU operations while seamlessly integrating with major EMR systems such as Epic, Cerner, and Meditech. We provide focused physician documentation training covering time requirements and procedure exclusions, along with hospital credentialing verification and payer enrollment confirmation. Most practices begin submitting clean claims within 10–12 business days, enabling a rapid and efficient transition to optimized critical care billing.
Practices experience immediate improvement in time-based claim acceptance, with procedure billing optimization beginning right away. Add-on codes such as 99292 are captured systematically, and transport services revenue is initiated where applicable. Previously denied claims are reworked and successfully recovered, leading to noticeable cash flow improvements within 30 days. On average, practices achieve a 28–35% increase in revenue by day 90.
Our ongoing oversight includes bi-weekly time documentation audits, monthly coding reviews conducted collaboratively with physicians, and quarterly compliance assessments to ensure sustained accuracy. Annual updates on CPT and documentation requirements keep teams aligned with evolving regulations. The long-term impact is continuous revenue optimization driven by steadily improving documentation quality.
Critical Compliance Issues We Handle
Critical care billing faces intense payer scrutiny. We protect you by managing:
30-minute time threshold documentation (exact start/stop times required)
Critical illness/injury definition (must meet severity criteria)
Time calculation accuracy (excluding separately billable procedures)
Procedure bundling rules (CCI edits, separately billable determination)
Medical necessity documentation (why the critical care level was required)
Multiple same-day encounters (when appropriate, proper documentation)
ED critical care requirements (distinct from ICU documentation)
Face-to-face time requirements (for transport services)
Place of service accuracy (ED vs ICU vs floor)
Discharge day management (when critical care vs discharge code)
We keep you compliant, paid, and audit-ready.
Free Download
Critical Care Denial Prevention Checklist
The exact pre-submission checklist our coders use for 97%+ clean claim rates.
Critical care time documentation template (30-minute threshold)
Separately billable procedure list during critical care
Medical necessity documentation templates
ED critical care documentation requirements
99291/99292 calculation worksheet (time increments)
Critical care vs hospital care decision tree
Transport service billing guide (99466-99467)
Pediatric/neonatal critical care code selector
Used by 125+ critical care groups. Worth $2,800. Yours free.
Frequently Asked Questions
10-14 days with zero claim disruption. We coordinate with hospital billing departments and handle credentialing.
Yes. We train physicians on time documentation requirements, procedure exclusions, and medical necessity standards.
We handle both private practice and hospital-employed billing models, including facility fee vs professional fee splits.
7-10% of collections (higher complexity warrants higher rates), but our clients average 28-35% revenue increase, netting 18-28% more than today.
Yes. We handle all teaching physician rules, resident supervision documentation, and attestation requirements.
We manage both with expertise in the distinct documentation requirements for each setting.
Yes. We specialize in critical care transport services (99466-99467) and ensure proper time documentation.
- Financial Attrition Warning
Stop Losing $40K-$90K Every Month
Every month you delay is another month of compounded clinical leakage.
Critical care claims were denied for insufficient time documentation
Procedures not billed separately (central lines, intubations)
Missing 99292 add-on codes for additional 30-minute increments
Transport services are not billed at all
ED critical care was underbilled as regular E/M visits
Downcoding to hospital care when critical care was provided
Physicians are frustrated with documentation requirements
Partner with Neo MD
Operational Performance Protocol
Transport services revenue initiated
2-4 days
Two Ways to Get Started
Option 1
Free Revenue Analysis
No obligation. No sales pitch. Just data.
We’ll show you:
- Time documentation accuracy
- Critical care vs hospital care code selection
- Procedure billing during critical care
- 99292 add-on code capture rate
- Transport service billing gaps
- Missed revenue by service category
Option 2
Talk to a Specialist
15-minute consultation. Zero pressure.
We’ll discuss:
- Your current billing challenges
- Molecular test denial patterns
- LCD compliance issues
- Whether Neo MD is the right fit
Or call us directly:
- (929) 502-3636
Monday-Friday, 8 am-5 pm EST
The Cost of Waiting
If you’re a critical care group collecting $5.5M annually and losing 30% to billing inefficiencies:
$1,650,000
Per year in lost revenue
$8.25 million
Over 5 years
That’s expanding ICU coverage, hiring additional intensivists, investing in telemedicine ICU, or building a transport program.
Every month you wait costs you $137,500 you'll never recover.
The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”
Neo MD Inc. | Critical Care Medical Billing Specialists
Maximizing revenue for critical care practices nationwide since 2021
Trusted by 115+ critical care groups across all 50 states