Skip to main content
Specialty Billing

Nephrology Billing Services

Nephrology Billing for Dialysis & Kidney Care Practices

Get a Free Billing Audit 346-307-9057

Specialty Focus

Nephrology Billing That Captures What You've Earned

Nephrology billing revolves around the unique monthly capitation payment model for dialysis patients, ESRD-related service bundling, and the complex transition from pre-ESRD CKD management to renal replacement therapy. This specialty demands billers with deep Medicare kidney care expertise.

Our nephrology billing team handles ESRD monthly capitation billing, dialysis session claim management, kidney biopsy coding, CKD chronic care billing, and the CKCC and ESRD Treatment Choices model requirements. We ensure every aspect of your nephrology practice — from the clinic to the dialysis center — is billed with precision.

97%
First-Pass Clean Claim Rate
24h
Average Claim Submission
40%
Average A/R Reduction
What We Handle

Key Billing Areas for Nephrology Practices

Every billing area below is managed by a specialist trained in your specialty's CPT, ICD-10, and payer requirements.

ESRD monthly capitation billing
In-center & home dialysis billing
CKD chronic care management billing
Kidney biopsy & procedure coding
Vascular access procedure billing
Acute kidney injury (AKI) claims
Transplant follow-up billing
Medicare ESRD compliance
Electronic remittance posting
Monthly performance reporting
Why Partner With Us

Built for Nephrology Billing Complexity

Specialty-Trained Coders

Our billers are trained in your specialty's CPT codes, ICD-10 diagnoses, and payer-specific rules — not generalists working across 50 specialties.

97%+ Clean Claim Rate

We scrub and submit clean claims the first time, reducing rework, accelerating payment, and improving your net collection rate.

24-Hour Denial Recovery

Every denied claim is reviewed within 24 hours, root cause identified, corrected, and re-submitted before payer appeal deadlines close.

Full HIPAA Compliance

Encrypted data handling, a signed Business Associate Agreement, and annual compliance audits — your patients' information is always protected.

Maximize Your Nephrology Revenue

Get a free billing audit and find out exactly how much revenue your practice could be recovering. No contracts, no obligation — just results.

HIPAA Compliant  •  No Long-Term Contracts  •  Results in 30 Days

Common Questions

Nephrology Billing — FAQ

Answers to the questions Nephrology practices ask us most before partnering with Prime Medical Billing.

Yes. ESRD Monthly Capitation Payments (MCP) for physician services are billed using G0491 (home dialysis) or G0490 (in-facility dialysis) and require monthly claim submission for every active ESRD patient. We track patient dialysis modality, ensure monthly claims are submitted without gaps, and audit for missed months that represent significant revenue loss.
Vascular access procedures — AV fistula creation, graft placement, catheter placement, and related interventions — are billed separately from the ESRD MCP and require proper CPT coding (36800–36870 series) with supporting operative documentation. We coordinate between the nephrologist and vascular surgery when both are involved in access management.
AKI (N17.x series) and CKD (N18.x series) have distinct ICD-10 codes with different clinical and billing implications. For hospitalized patients, we coordinate with your coders to ensure the correct principal diagnosis drives DRG assignment. For outpatients, we ensure stage-specific CKD coding is applied to capture care management revenue.
Medicare Advantage plans have their own prior authorization requirements, network rules, and sometimes different fee schedules than traditional Medicare. We verify MA plan enrollment for every dialysis patient, track plan-specific auth requirements for procedures, and ensure correct payer routing to avoid claim rejections.