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Pediatric billing services · Well-child · Vaccines · Medicaid
PhysiAssist runs billing for pediatric practices: well-child and sick visits, vaccines and administration, developmental screenings, newborn care, and Medicaid and CHIP plans. We count every vaccine component and screening the visit supports, and follow each state plan's rules.
Vaccine administration codes
Try itAdministration
Products
CPT vaccine administration rules; injections only
The basics
Pediatric billing services manage the revenue cycle of a pediatric practice: well-child and sick visits, vaccine products and administration, developmental and behavioral screenings, newborn and hospital care, Medicaid and CHIP plans, payment posting, denials and AR. In pediatrics, vaccine counseling codes and screenings are where revenue most often goes uncounted.
Preventive visits by age, with same-day sick visits billed when documented.
Products and administration by component, including Vaccines for Children rules.
Standardized screenings billed per instrument alongside the visit.
State plan enrollment, coverage and visit rules applied to every claim.
What we check
| Codes | What they cover | What we check |
|---|---|---|
| 99381–99385 · 99391–99395 | Preventive visits by age, new and established | Age band and same-day sick visit with 25 |
| 90460 · 90461 | Vaccine administration with counseling, under 19 | First and additional components counted per vaccine |
| 90471 · 90472 | Vaccine administration without counseling | First and additional injections |
| 90707 · 90700 · 90716 · 90744 | MMR, DTaP, varicella, hepatitis B products | Product billed, or administration only for VFC stock |
| 96110 · 96127 | Developmental screening, emotional or behavioral assessment | Per standardized instrument, documented |
| 99460 · 99462 · 99238 | Newborn initial and subsequent care, discharge | Dates, setting and discharge day rules |
| 99202–99215 | Sick visits, new and established | Level supported by decision making or total time |
Free pediatric billing audit
Send us a recent month of well-child, vaccine and sick visit claims. A certified coder checks every one and sends a written report you keep, whether or not you work with us.
Claims reviewed
700With an issue
52Dollar impact
$9,800What the report covers
Office, hospital and Medicaid
Pediatric practices see every age, under many plans. We bill each visit to the plan's rules and count every vaccine and screening.
The systems we work in every day
We log in to your system; nothing about it changes for your team.
Claims, rejections and remittances worked through your clearinghouse.
Submissions, status checks and renewals in each payer's own portal.
Pricing
One rate of 2.8% to 5% of net collections, quoted in writing before you sign. Where you land depends on monthly collections, specialty mix, the scope of services, and your AR backlog and payer mix.
The rate covers medical coding, claim submission, payment posting, denials and AR follow-up. Front desk services, prior authorization, the reporting dashboard, patient statements, credentialing and digital marketing are quoted separately.
See full pricing and estimate your rate →Eligibility checks, well-child visits, sick visits, vaccines and administration, developmental and behavioral screenings, newborn and hospital care, Medicaid and CHIP plans, payment posting, denials, AR follow-up and patient billing.
For patients under 19 when a physician or qualified provider counsels on each vaccine, 90460 is billed for the first component of each vaccine and 90461 for each additional component. Otherwise 90471 and 90472 are billed per injection.
Yes, when a significant, separately documented problem is addressed. The preventive code is billed with an E/M code and modifier 25.
Standardized developmental screening is billed with 96110 and brief emotional or behavioral assessment with 96127, per instrument, in addition to the well-child visit.
Yes. We bill state Medicaid, CHIP and managed Medicaid plans with their enrollment, vaccine program and visit rules, including Vaccines for Children products billed for administration only.
Yes. Newborn care in the hospital, discharge and follow-up visits are billed with the right codes and dates.
PhysiAssist charges 2.8% to 5% of net collections for coding, claims, payment posting, denials and AR, quoted in writing before you sign.
We review recent well-child, vaccine and sick visit claims and send a written report: vaccine product and administration coding, screenings, same-day sick visits, Medicaid and VFC rules, denials by root cause and the dollar value of each.
A free pediatric billing audit by a certified coder, with a written report you keep.