Expert Nephrology Billing Services with AI-Powered RCM
Transcure’s nephrology billing services assign AAPC-certified coders backed by dedicated nephrology billing AI agents. Our nephrology billing team provides the following services to fix revenue leaks across your CKD, dialysis, and renal failure claims:
- Full Compliance with HIPAA, Stark Law, AKS, and CMS ESRD PPS Rules via automated pre‑submission audits and quarterly referral reviews.
- AI-Powered Nephrology RCM (ELIXA, PRIA, CODIN, DEXA) from Eligibility Verification to Final Collections
- Prevent Claim Denials by Using Accurate ICD-10, CPT, & HCPCS Codes
- Manage CKD, ESRD, and Dialysis Billing with Stage-Specific Documentation
- Accurate Nephrology Coding Across CPT 90960 to 90962 Based on Visit Frequency
- ESRD QIP Documentation Support to Prevent 2% Medicare Payment Reductions
Our Success in Numbers
Trusted by
500+ Physicians
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
End-to-End
RPA Billing Solutions
Up to 98% First Pass
Clean Claim Rate
Why Do Practices Need an Expert Nephrology Billing Company for Financial Growth?
The AMA estimates that up to 12% of medical claims are submitted with inaccurate codes, resulting in denials or payment delays. The numbers climb further under Medicare’s strict ESRD PPS bundled payment rules and CKD stage-specific documentation requirements from CMS. That’s why nephrologists across the United States should look to outsource billing services to experienced nephrology-focused companies.
Nephrology Practices That Have Put Trust in the Transcure Billing Team
Many nephrology practices have trusted the Transcure billing team for their revenue cycle management needs. Over the years, we have partnered with a wide range of providers, from small independent nephrologists to large multi-location renal care groups. Some of the prominent ones include:
What Nephrology Billing Services Transcure Offers to Maximize Revenue?
How Does Transcure Handle Different Laws and Challenges Affecting Nephrology Billing?
Transcure assigns nephrology-trained billing specialists who track CMS rule changes, apply correct ESRD codes, and prevent compliance violations. Our nephrology medical billing services cover
ESRD Prospective Payment System
CMS bundles dialysis drugs, labs, and supplies into one per-treatment payment under the ESRD PPS base rate of $281.71 for CY 2026. Transcure's CODIN tool maps each service to its current bundled or separately billable status.
Dual-Eligibility Billing Errors
ESRD qualifies patients for Medicare regardless of age under 42 CFR § 406.13. Transcure verifies Medicare-Medicaid coordination of benefits through ELIXA before every claim drops, eliminating payer ID and sequencing errors at submission.
Documentation and Coding Gaps
CMS requires stage-specific ICD-10-CM codes N18.1 through N18.6 for CKD. Our nephrology billing team cross-checks physician notes against billed diagnosis codes and returns documentation deficiency alerts before claim release.
Stark Law and AKS Referral Protection
Stark Law and AKS violations carry penalties up to $34 million per DOJ enforcement data. Transcure audits your referral patterns quarterly. Flagged arrangements reach your legal counsel before claims drop.
How Transcure Helped the Idaho Kidney Institute with Their Nephrology Medical Billing?
Idaho Kidney Institute carried $300,000 in unpaid claims stuck in the 60+ bucket. Transcure’s billing team cut that backlog to $100,000 within 90 days. Denial rates dropped across every category with missing information, medical necessity, invalid ICD codes, and modifier errors.
Claims billed as self-pay to insured patients were caught, verified, and resubmitted to correct payers. Dr. Fahim Rahim called Transcure “more than a billing partner — a trusted ally.” Your nephrology practice faces the same denial patterns IKI did. The difference is how fast you act on them.
What Procedures Does Transcure Support with Their Nephrology Medical Billing Services?
Transcure provides nephrology billing support for high-cost renal procedures governed by strict Medicare and commercial payer rules. Our certified billing experts manage every procedure, including but not limited to.
Hemodialysis Billing
We handle accurate coding for hemodialysis sessions, including time-based reporting and ESRD documentation required by payers.
Peritoneal Dialysis Billing
Our nephrology medical billing company manages continuous and intermittent peritoneal dialysis billing, including training sessions and modifier application.
Dialysis Catheter Placement Billing
Transcure handles tunneled and non-tunneled catheter placement, exchange, and removal billing with correct modifier usage throughout.
CKD Billing
We bill stage-specific E/M services across N18.1–N18.6 with proper diagnosis linkage and frequency compliance.
Renal Biopsy Billing
Transcure's billing experts code percutaneous and image-guided renal biopsies with accurate CPT assignment and pathology coordination.
Kidney Transplant Billing
Our team bills pre-transplant recipient evaluations, living donor assessments, and transplant clearance documentation required by payers.
Nephrology Billing Services Serving Every State in the United States
Transcure offers specialized nephrology billing services across the United States. Our remote operations and local presence enable us to serve nephrology practices nationwide, including the following states.
Our Expertise in Nephrology CPT Codes and ICD-10 Coding
With years of experience in nephrology billing and coding, we specialize in accurately handling nephrology CPT codes and nephrology ICD-10 codes for renal care. Our nephrology coding expertise spans across.
90960 to 90962
- ESRD CPT codes for monthly capitation payment
90935 to 90937
- Hemodialysis CPT code for evaluations
90945 to 90947
- Peritoneal dialysis CPT code for evaluations
90951 to 90959
- Dialysis CPT codes for age-specific ESRD services
G0317 to G0319
- Home dialysis transitional care management HCPCS codes
N18.1 to N18.6
- ICD 10 code for CKD stages one through five
N18.6
- ICD 10 ESRD requiring chronic dialysis or transplant
N20.0 to N20.9
- Kidney stone ICD 10 for calculus of the kidney and ureter
E11.21
- Diabetic nephropathy ICD 10 with type 2 diabetes mellitus
Is Your Practice Ready for 2026 Nephrology Billing Changes?
CMS raised the ESRD PPS base rate to $281.71 under CMS-1830-F effective January 1, 2026. The AX modifier requirement drops on July 1, 2026. AMA released 288 new CPT codes that your coders must apply correctly from day one.
One missed update means denied claims stacking in your AR. Transcure’s CODIN tool already maps every 2026 rate change, modifier update, and telehealth code to your nephrology claims before submission. Your practice bills at current rates or loses revenue to outdated workflows.
Why Should Practices Outsource Nephrology Billing Services to Transcure?
Transcure delivers customized nephrology billing solutions that simplify coding, reduce errors, and improve reimbursements. Below are the key reasons practices rely on Transcure for nephrology billing services:
Multi-Specialty Nephrology Billing
Transcure has expertise across billing multiple nephrology specialties, including transplant nephrology, pediatric nephrology, and hypertension kidney care.
Transparent Pricing
We offer percentage-based nephrology billing at around 3 to 5% of monthly collections, which reduces in-house expenses by up to 30%.
Reduced Administrative Overhead
Hiring one certified nephrology coder costs $52,000 annually per BLS wage data. Transcure replaces fixed payroll with variable billing fees tied to collections.
Dedicated Account Manager
Transcure assigns a dedicated nephrology billing account manager who is available 24/7 to resolve issues and answer queries.
Supports Major Nephrology EHRs
Your nephrology billing workflow will never get disrupted, as we integrate with 40+ major nephrology EHRs, including eClinicalWorks, AdvancedMD, and NextGen.
Compliance with Nephrology Billing Laws
Our nephrology medical billing team follows ESRD PPS, Medicare dialysis rules, QIP, and CMS guidelines for an accurate claim submission process.
Our Certifications
Transcure’s nephrology billing team holds industry-recognized certifications to make sure that renal claims meet CMS compliance standards and payer-specific coding requirements.
What Nephrology EHR Systems Are Supported by Transcure?
Transcure’s nephrology billing company integrates directly with every major renal EHR platform your practice uses. Our coders extract documentation from your existing system without disrupting clinical workflows.
Trusted by Thousands Across the Nation
Our results speak for themselves, as we are consistently rated top-tier nephrology billing company by clients on every major review platform.
What Practices Say About Our Nephrology Medical Billing Services?
Explore the success stories of our partnered practices to see how our outsourced nephrology billing service helps nephrologists improve revenue.
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 About Nephrology Billing
Get answers to the most common questions nephrology practices ask about our billing services, ESRD compliance, and CMS reimbursement rules.
What is Nephrology Billing?
Nephrology billing is how your practice gets paid for kidney care services. It covers CKD management, dialysis coding, ESRD monthly payments, transplant evaluations, and vascular access procedures. It runs on Medicare rules because most dialysis patients qualify for Medicare regardless of age.
What CPT Codes are Used For Dialysis Billing?
The most common CPT codes for dialysis billing are 90960 to 90962 for ESRD monthly capitation based on visit count. Hemodialysis uses 90935 and 90937. Peritoneal dialysis uses 90945 and 90947. If a patient gets hospitalized, you bill daily using 90970.
Why Do Nephrology Billing Claims Get Denied So Often?
Most denials come from missing CKD stage codes, wrong MCP visit counts, bad payer sequencing on dual-eligible patients, and missing modifiers. Nephrology has more moving parts than most specialties because of bundled payments and strict Medicare documentation rules.
How Much Does Transcure Charge for Nephrology Medical Billing?
Transcure charges between 3% and 5% of monthly collections for nephrology billing services. Your rate depends on practice size, claim volume, payer mix, and ESRD patient count. No setup fees. No long-term contracts. Your practice pays only when Transcure collects.
What is the New ESRD PPS Base Rate For 2026?
CMS raised it to $281.71 per treatment, up $7.89 from the 2025 rate of $273.82. That reflects a 2.1% market basket update minus a 0.8% productivity adjustment.
Nephrology Billing Knowledge Center
Explore the latest nephrology billing insights to enhance practice performance and profitability.
Nephrology Billing: Definition, Codes, Process, and Guidelines
04/01/2026
Learn everything about nephrology billing, including CPT and ICD-10 codes, dialysis and ESRD rules, MCP guidelines, and billing processes.
10 Best Nephrology Billing Companies in the USA [2026]
04/07/2026
Reduce denials, streamline revenue, and support your practice’s growth with expert nephrology medical billing companies.
Nephrology CPT Codes and Common Modifiers Explained
04/06/2026
Learn about the most common nephrology CPT codes, frequently used modifiers, and strategies to avoid claim denials.