Pain Management Billing Services with New York Compliant Workflow
Our pain management billing company helps your practice:
- Manage New York no-fault pre-authorizations to minimize denials
- Cover procedures widely billed in NY, including epidural steroid injections
- Handle New York requirements, including 10 NYCRR Part 63 safeguards
- Take care of high-frequency NY pain codes, including 64483 and 64636
- Apply SPARCS submission protocols to prevent NY state reporting penalties
What Pain Management Billing Challenges Do New York Practices Commonly Face?
Pain management practices in NY face billing challenges, as follows:
- Frequent Prior Authorization Requirements: Pain procedures like SI joint injections and spinal cord stimulators often require multiple rounds of justification before approval.
- Strict Payer Scrutiny on Medical Necessity: Pain management services in New York have to provide detailed proof of treatments and pain scale progress before reimbursement.
- Frequent Insurance Audits: Because of opioid-related oversight, NY pain management practices encounter more chart audits compared to many other specialties.
- SPARCS Reporting Obligations: A pain management billing company must submit accurate encounter data to the NY State Department of Health, and errors can lead to delays.
How Transcure Helps NY Practices With Their Pain Management Billing Services?
Insurance Verification and Eligibility Checks
We confirm coverage for follow-up injection series, imaging, and long-term treatment cycles to prevent surprise denials.
Prior Authorization and Pre-Certification
With our NY pain management billing services, you can secure authorizations for spinal cord stimulators, opioid tapering plans, and multi-level procedures.
New York Regulatory Compliance
Our billing workflows align with I-STOP reporting, NY DUR requirements, and chronic opioid management documentation standards.
Pain-Specific Coding and Charge Capture
Transcure’s expert coders apply CPT, ICD-10, and modifier coding correctly for procedures, such as 64635 and 62323, to avoid underbilling.
Claim Submission and Denial Management
We submit clean claims, resolve disputes, and handle appeals for pain management procedures flagged for medical necessity review.
AR Recovery and Financial Reporting
Our pain management billing experts in New York monitor AR aging and payer performance to provide clear financial visibility.
Our Success in Numbers
Which Cities Does Transcure Serve with Their NY Pain Management Billing Services?
New York City
Buffalo
Rochester
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Yonkers
Syracuse
Albany
New Rochelle
Mount Vernon
Schenectady
How Much NY Practices Save by Outsourcing Pain Management Billing to Transcure?
According to ZipRecruiter, the average Medical Billing Specialist in New York earns about $46,675 per year. Instead of a fixed in-house salary, Transcure charges only 5% of the revenue collected for your pain management practice. So there is no fixed staff salary, no recruitment cost, and no ongoing administrative overhead.
For a practice generating $250,000 in annual collections, Transcure’s fee would be $12500, versus an in-house biller at $46,675. So, by outsourcing pain management billing in New York, your practice will save around $34,175.
Which Counties Benefit from the Transcure Pain Management Billing Services in New York?
Kings County (Brooklyn)
Queens County
New York County (Manhattan)
Suffolk County
Bronx County
Nassau County
Westchester County
Erie County
Monroe County
What Different Pain Management Procedures Does Transcure Handle with Their NY Billing Services?
Transcure has expertise in handling each pain procedure with payer-specific compliance. Our New York pain management billing services cover the following:
Epidural Steroid Injection Billing
We manage CPT coding for cervical, thoracic, and lumbar epidural injections, including ultrasound guidance and multi-level documentation for full reimbursement.
Facet Joint Injection Billing
Our NY pain management billing team accurately codes unilateral, bilateral, and multi-level facet injections and MBBs with correct modifier usage to prevent underbilling.
Spinal Cord Stimulator Billing
Transcure’s billing experts in New York manage authorization, trial-to-permanent conversion documentation, and implant follow-up billing for maximum collections.
Radiofrequency Ablation Billing
With our pain management billing expertise, your practice can handle thermal and pulsed RFA billing, including imaging guidance and medical necessity notes required by NY payers.
Peripheral Nerve Block Billing
We handle ultrasound and fluoroscopic guidance coding, differentiating between single-shot and continuous catheter-based nerve blocks for accurate claim submission.
Regenerative Pain Therapy Billing
Transcure supports billing for routine and high-risk pregnancy ultrasounds, including imaging guidance and documentation required for payer compliance and full reimbursement.
Why Should You Outsource Pain Management Billing in New York to Transcure?
With many billing companies available, Transcure stands out through strong New York pain care expertise. Here’s what you gain with us:
SPARCS Data Submission and Reporting
Our pain management billing experts manage SPARCS submissions for interventional pain visits to prevent filing errors and reimbursement penalties.
Dedicated New York Pain Billing Manager
You’ll work with a billing lead who understands NY Medicaid, No-Fault, and prescription monitoring documentation requirements.
Transparent AR and Revenue Reporting
With our pain management billing services, you will receive clean monthly AR reports and payer performance insights for consistent financial clarity.
Accurate Multi-Level Pain Coding
Transcure’s certified coders focus on correct CPT, add-on, and modifier usage for facet blocks, SI injections, and other spinal procedures.
Keep Your New York Pain Management Billing Aligned with the Laws and CPT Changes
Pain management practices in New York must stay current with new state billing mandates and procedure codes. Transcure makes sure that your billing remains optimized as these laws and codes changes roll out.
- As of August 1, 2025, the NYS Workers’ Compensation Board now requires CMS-1500 forms to be submitted electronically through a Board-approved partner.
- New York legislation (S5456 / A7981 and related bills) is moving toward requiring providers to make medical records electronically available to insurers and utilization reviewers.
- The 2026 CPT code set adds many codes (including digital health). Pain practices using remote patient monitoring or advanced device follow-ups should confirm changes for 2026.
Which Pain Management EHRs Does Transcure Support?
Our team masters pain management‑specific modules in the following EHRs to ensure error-free billing and coding.
How Pain Management Practices Benefit from Our Medical Billing Services?
Read our partners’ success stories to recognize the worth of our pain management billing services for financial growth.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions (FAQs)
What is the No Surprise Act in New York?
New York’s No Surprises Act protects patients from unexpected medical bills when treated by out-of-network providers without their knowledge. It makes sure that they pay only the in-network cost, regardless of provider participation.
Does Transcure handle billing for non-invasive pain management procedures?
Yes, we manage billing for both invasive and non-invasive treatments, including physical therapy, acupuncture, and TENS therapy.
How long after providing pain management services can a provider bill patients in NY?
In New York, billing timelines for pain management practices vary by payer type:
- Insurance claims (including Medicaid) generally must be submitted within 120 days of the treatment date.
- Patient billing falls under a three-year statute of limitations, meaning charges older than three years usually can’t be pursued.
In short, providers should file insurance claims within about four months and issue patient bills within three years of delivering pain management services.