Specialty Medical Billing Services for US Practices
Specialty medical billing is billing done by a team that knows the codes, modifiers, authorization rules and documentation each specialty's payers check. MB Claims provides specialty medical billing for behavioral health, cardiology, urgent care, PT/OT, DME and internal medicine practices across the US. We work inside your existing EHR, at 2.99%–6% of collections or $1,000 per month, whichever is higher.
Summary
Most denials are specialty-specific: visit limits and carve-outs in behavioral health, imaging authorizations in cardiology, timed units in therapy, documentation packets in DME. Pick your specialty below to see where claims commonly go wrong, then request a free audit to see where yours do.
Specialties at a glance
| Specialty | Where claims commonly get denied | Guide |
|---|---|---|
| Mental & behavioral health | Authorizations and visit limits, behavioral health carve-out routing, telehealth place-of-service and modifiers, non-physician clinicians not yet enrolled | Behavioral health billing → |
| Cardiology | Prior authorization for imaging and diagnostics, NCCI bundling, professional vs technical component (modifiers 26/TC) | Cardiology billing → |
| Urgent care | Eligibility for walk-ins, E/M plus same-day procedures (modifier 25), missed charges for point-of-care tests | Urgent care billing → |
| Physical & occupational therapy | Timed-unit calculations, plan-of-care certification, Medicare therapy threshold (KX modifier), visit authorizations | PT/OT billing → |
| Durable medical equipment (DME) | Missing documentation (orders, medical necessity, proof of delivery), prior authorization, coverage criteria | DME billing → |
| Internal medicine | E/M documentation level, preventive plus problem visit on the same day, chronic care management requirements | Internal medicine billing → |
Why does specialty matter in medical billing?
Payers apply different rules to different kinds of care. A billing team that mostly handles routine office visits will miss the details that drive specialty denials. Examples include a therapy plan of care that has lapsed, a cardiology study billed without the right component modifier, or a behavioral health claim sent to the medical plan instead of the carve-out. Specialty billing means:
- Scrubber edits and checklists built around your specialty's common denials
- Authorization tracking for the services your payers require it on
- Coding review by our AAPC-credentialed coding support team against the documentation your specialty's payers ask for
- Reporting that shows denial categories by cause, so problems get fixed upstream
How specialty billing works with MB Claims
- Free audit. Send summary reports. We sort your denials and aging by cause and send back a written review within 5 business days. What's in the audit →
- Written scope and rate. We put the work, the reporting and your percentage (2.99%–6% of collections, $1,000 monthly minimum) in writing. Pricing →
- BAA and access. We sign a Business Associate Agreement before we access PHI. You create user accounts for our team in your systems. HIPAA & security →
- Monthly reporting. Denial categories, days in A/R and aging by payer, with an owner assigned to each problem.
Is "speciality medical billing" different?
No. "Speciality" is the British spelling of "specialty." Both mean billing that's tailored to the rules of a particular medical specialty.
Don't see your specialty?
We also support multi-specialty groups and other outpatient practices. Start with our medical billing or revenue cycle management pages, or tell us about your practice in the form below.
Build a specialty-aware billing plan
· hello@mbclaims.comCommon questions
Specialty billing FAQ
What is specialty medical billing?
Billing handled by a team that knows the codes, modifiers, authorization rules and documentation requirements for a specific specialty, so specialty-specific denials are prevented instead of just reworked.
Which specialties does MB Claims support?
Mental and behavioral health, cardiology, urgent care, physical and occupational therapy, DME, and internal medicine, plus multi-specialty groups.
How much does specialty medical billing cost?
MB Claims charges 2.99%–6% of collections or $1,000 per month, whichever is higher. More complex specialties and payer mixes generally sit higher in the range. Your rate is set after a free audit.
Do you work in our EHR?
Yes. We work in Epic, eClinicalWorks, NextGen, AdvancedMD and PracticeSuite, and we also work inside your existing EHR or PM system if it's a different one. You don't need to switch software.