MedCare Billing Solutions provides specialized pediatric medical billing for general pediatricians, pediatric subspecialists, and children's hospitals. From well-child visits and vaccine administration to complex developmental screenings — we ensure every service is coded and collected correctly.
Pediatric practices deal with some of the highest claim volumes and lowest per-claim values in medicine — meaning billing errors hurt more. The most costly billing mistakes in pediatric practices include:
The average pediatric practice misses $80,000–$150,000/year in immunization administration fees alone — one of the most underbilled service categories in all of medicine. Our pediatric coding specialists ensure complete capture of every billable service.
| CPT Code | Service | Common Billing Issue |
|---|---|---|
| 99381–99385 | New patient preventive well-child visits | Wrong age category selected; missing components billed separately |
| 99391–99395 | Established patient preventive well-child visits | Billed as E/M instead of preventive; lower reimbursement result |
| 90460–90461 | Immunization administration with counseling | Only billing 90471 instead of age-appropriate 90460 series |
| 96110 | Developmental screening | Bundled into E/M instead of billed separately |
| 99401–99404 | Preventive counseling (15–60 min) | Underbilled or missed entirely for obesity/smoking counseling |
| 99213 + modifier -25 | Sick visit same day as well-child | Only one visit billed; $80–$150 per encounter lost |
| 96127 | Behavioral health screening (PHQ-A, MCHAT) | Not billed separately from E/M code |
Complete immunization billing including vaccine supply codes, administration codes, and counseling add-ons. We ensure full capture of every immunization encounter.
Age-appropriate preventive visit coding with separate billing for screenings, counseling, and same-day sick visits using correct -25 modifier.
Separate billing for MCHAT autism screening, PHQ-A depression screening, developmental milestone assessments, and ADHD screening tools.
Expert Medicaid and CHIP billing across all states. We know the payer-specific rules for preventive care, EPSDT, and specialty referrals.
Pediatric practices see 40–80+ patients per day. Our high-volume processing workflow handles same-day charge entry and 24-hour claim submission.
Pediatric cardiology, neurology, pulmonology, gastroenterology, and endocrinology — we handle all pediatric subspecialty billing needs.
Get a free pediatric billing audit. We'll analyze your vaccine administration billing, well-child visit coding, and screening capture — and show you exactly what you're missing.