HelloMDs codes and files every geriatric Medicare claim by CPT number, so your practice collects what it’s owed each month
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Geriatric patients rarely fit one billing code. A single visit might involve an Annual Wellness Visit, a discharge follow-up under Transitional Care Management, and ongoing Chronic Care Management for three or more conditions, each with its own time minimum, modifier, and deadline. Miss one and Medicare denies the claim. The 2026 Physician Fee Schedule raised the conversion factor and spared these time-based codes from the cuts hitting procedural billing, rewarding practices that code them correctly.
HelloMDs codes and files geriatric claims by CPT number, not guesswork, so your practice collects what 2026’s rules actually pay for.
Four problems account for most denied claims in a geriatric practice
Overlapping Care Codes - A patient can qualify for AWV, CCM, and TCM in the same month; billing the wrong pair together triggers a denial.
Strict TCM Deadlines - Transitional Care Management needs patient contact within two business days and a visit within seven or fourteen days, or it can't be filed.
ACP Modifier Rules - Advance Care Planning needs modifier 33 when billed with a wellness visit, and different rules with an office visit; mixing them up causes denials.
Caregiver Consent Gaps - Many patients rely on a power of attorney or family caregiver; claims need clear notes on who consented and why.
AAPC-certified coders who work CCM, TCM, AWV, and ACP codes daily, not as occasional entries in a general specialty list.
Office visits, skilled nursing, assisted living, and home-based geriatric practices bill through one team, with no gaps at transitions.
Claims go out correctly across all 50 states and U.S. territories, where dual-eligible Medicaid rules shift state to state.
Dashboards show every AWV, CCM, and TCM claim status, so nothing sits unresolved without your knowledge.
Plans start at 2.95% of monthly collections, so cost scales with what actually gets paid.
We track staff time against CPT 99490 (20 minutes) and 99487/99489 (60 minutes, complex), then pair each condition with its correct ICD-10 code; common ones include I10 for hypertension and E11.9 for type 2 diabetes.
G0402 covers a patient’s first year on Medicare; G0438 and G0439 cover every visit after. We code the right one and screen for cognitive decline.
After a hospital or skilled nursing discharge, we log the two-day contact deadline and file 99495 or 99496 based on the decision-making complexity documented.
CPT 99497/99498 pay for care-planning conversations; 99483 covers a cognitive exam. CMS excludes them from the same claim, and we apply the right modifier for whatever else is billed that day.
Many geriatric patients carry Medicare and Medicaid together. We confirm both before the visit and bill the correct payer first.
01
AWV, CCM, and TCM claims go out coded and filed within days of each visit, not weeks.
02
Modifier and timing checks catch errors before submission, so fewer claims bounce back for rework.
02
Chronic care management minutes get logged and billed monthly instead of going unbilled.
03
Your staff spends less time on claim forms and payer phone calls each week.
04
You see collections, denials, and aging claims in one report, without chasing your billing team.
| Challenges | How HelloMDs Fixes It |
|---|---|
| TCM Timing Missed | We flag every discharge same-day and schedule the face-to-face visit before the 7 or 14-day window closes. |
| AWV-ACP Modifier Errors | We apply modifier 33 for wellness-visit ACP and check every same-day pairing against CMS's exclusion list. |
| CCM Time Under-Documented | We log staff minutes per patient per month and hold claims that fall short of the 20-minute threshold. |
| Cognitive Screening Missing | We confirm a Mini-Cog, MoCA, or MMSE score is charted, and keep 99483 off the same claim as ACP. |
| Dual-Eligible Payer Confusion | We verify Medicare and Medicaid together and bill the primary payer first. |
| Setting Mismatches | We match the billed setting to where care happened: home, assisted living, or skilled nursing. |
Send us last month’s denied claims. We’ll show you which ones should have been paid, at no cost.
It combines standard E/M coding with time-based Medicare programs, each with its own code, time minimum, and modifier. Missing one piece can trigger a denial.
CPT and ICD-10 coding, claim submission, denial resolution, payment posting, Medicare/Medicaid eligibility checks, and credentialing across office, home, and skilled nursing settings.
Most denials trace back to timing, modifiers, or missing documentation like a charted cognitive screening score, caught before submission rather than after denial.
Yes for patients with two or more chronic conditions expected to last 12 months or longer. CPT 99490 covers the first 20 minutes; 99487/99489 apply past 60 minutes.
A dedicated team tracks each patient's eligible codes so time-based services that often go unbilled in a busy practice get captured and filed on time.
