Dermatology Billing Services | Protect Same-Day Visit Revenue and Keep Denials Under 1%
Transcure’s HIPAA-compliant dermatology billing services code and bill every claim in one team, holding denials under 1% as payers scrutinize same-day visits. Our dermatology medical billing services cover:
- Same-day E/M visits documented for modifier 25 before the claim drops.
- Excisions coded by lesion size plus margins, with benign or malignant set by pathology
- Mohs stages and tissue blocks counted and billed on every case
- Cosmetic removals kept off insurance claims under Medicare’s cosmetic exclusion
- PA and NP visits billed under incident-to rules or their own NPI
- End-to-end dermatology revenue cycle management, from eligibility to A/R recovery
Our Success in Numbers
Results vary by practice size, specialty and payer mix. Across Transcure clients, these are typical results:
Thousands of Specialty
Practices Trust Transcure
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
Seven Proprietary
AI Agents
98% First Pass
Clean Claim Rate
Practices That Trust Our Dermatology Billing Services
Dermatology and skin care practices rely on Transcure for dermatology billing service support across medical, surgical, and cosmetic work. We bill for independent dermatologists, combined dermatology and med spa practices, and plastic surgery groups whose claims share excision and repair rules, including:
How Do Our Dermatology Billing Services Improve Revenue for Practices?
Our dermatology billing services raise revenue by billing every lesion, stage, and visit the chart supports. A single dermatology encounter can carry an E/M visit, several biopsies, a destruction, and a pathology read. Since each piece follows its own counting rule, even a single miss shrinks the claim without triggering a denial.
Transcure codes and bills dermatology claims inside one team, so lesion sizes, margins, and add-on codes match the note before submission. Our dermatology medical billing approach cuts silent underpayments, clears denials at the front end, and shortens A/R in the first months of outsourcing.
Why Do Dermatology Practices Lose Revenue on Claims That Get Paid?
Dermatology practices lose revenue when payers pay exactly what was billed, and what was billed was short. These losses never show up as denials. They hide in undersized codes, missing units, and unbilled visits at each stage of the dermatology billing workflow. Our review starts with paid claims for that reason.
Excisions Coded Without Margins
Excision codes are chosen by the lesion's diameter plus twice the narrowest margin. When the note records only lesion size, the claim drops a size tier and pays less for completed work.
Actinic Keratoses Undercounted
Premalignant destruction bills 17000 for the first lesion, 17003 for each lesion from two through 14, and 17004 alone at 15 or more. A count that stops short leaves units unbilled.
Same-Day Visits Left Unbilled
When modifier 25 audits feel risky, a practice may stop billing these visits. A separately identifiable E/M with clear documentation is payable, and dropping the visit gives away revenue the physician earned.
Claims Sent Before Pathology Returns
Benign and malignant excisions use different code ranges, and the diagnosis must match the code. Billing before the pathology report arrives forces a guess that leads to underpayment, denial, or a corrected claim.
Which RCM Steps Does Our Medical Billing for Dermatology Cover?
Our RCM medical billing for dermatology runs through seven AI agents and AAPC-certified coders, with each step owned end to end. Here is how Transcure handles a dermatology claim, from the first eligibility check to the final payment:
Which Medicare Rules Do Our Dermatology Billing Specialists Track in 2026?
Our dermatology billing specialists track four Medicare rules that decide whether dermatology claims pay in 2026. Coverage policy, supervision, fee schedule changes, and audit topics all hit the specialty at once. Our team applies each rule before submission, so problems surface in review rather than in a denial:
Benign Lesion Removal and the Cosmetic Exclusion
Medicare contractors cover benign lesion removal only when the record shows a sign such as bleeding, intense itching, pain, inflammation, or recent change. Location alone does not qualify. Transcure matches each removal to documented findings before billing.
Incident-To Billing for PAs and NPs
Incident-to services pay 100% of the fee schedule only under strict rules. The physician must perform the initial service and stay actively involved. Direct supervision can be in person or by real-time audio-video, except for services with a 10- or 90-day global period. Transcure routes every PA and NP visit to the correct NPI and handles credentialing for providers billing under their own NPI.
2026 Physician Fee Schedule Efficiency Adjustment
The CY 2026 Medicare Physician Fee Schedule applies a -2.5% efficiency adjustment to non-time-based services, including biopsies, excisions, destructions, and Mohs surgery. E/M visits are exempt. Transcure loads the 2026 rates, so underpaid lines are caught at posting.
Mohs Units on the Recovery Audit List
CMS lists Mohs micrographic surgery as an approved Recovery Audit Contractor review topic. Auditors confirm the surgeon also read the pathology and check units billed for 17312 and 17314. Transcure counts stages from the operative note.
How Did Transcure Clear MD Vein & Skin Specialists' A/R Backlog and Correct Payment Posting?
MD Vein & Skin Specialists, Dr. Clement Banda’s dermatology and vein practice in Columbia, Maryland, came to Transcure with a significant A/R backlog. Payment posting had broken down too. Negative and incorrect postings meant the practice couldn’t trust its ledger for open balances.
Transcure wrote a standard operating procedure to work the backlog and prioritized aged A/R claims. Our team recovered as much reimbursement as the claims allowed and significantly cut the backlog. We reviewed every negative posting, corrected the errors, and reposted payments accurately. The practice has confirmed its billing is now in good order.
Is aged A/R or messy payment posting holding your dermatology practice back?
Dermatologist, MD Vein & Skin Specialists, Maryland
“Our A/R backlog kept growing, and the payment posting errors made it impossible to know which balances were real. Transcure set up a clear process, went after the oldest claims first and fixed every negative posting. Today our payments are posted correctly, and I can trust the numbers I see each month.”
How Do Our Dermatology Billing and Coding Services Handle Different Procedures?
Our dermatology billing and coding services cover the procedures where one documentation detail changes the payment. Mohs, biopsies, excisions, destructions, pathology, and cosmetic care each follow separate rules for the dermatology CPT codes behind them. Our coders apply those rules on every claim:
Mohs Surgery Billing
We bill 17311 through 17315 by anatomic site, stage, and tissue block, using 17315 for each block after the first five in any stage. Every claim confirms the same physician acted as surgeon and pathologist, as CMS requires.
Skin Biopsy Billing
Our coders select biopsy codes by method: tangential (11102), punch (11104) or incisional (11106). The highest-valued method becomes the single primary code, and additional lesions go through add-ons 11103, 11105, and 11107.
Lesion Excision Billing
We code benign excisions (11400 to 11446) and malignant excisions (11600 to 11646) from lesion diameter plus margins. Claims wait for pathology, and intermediate or complex repairs are billed separately when documented.
Lesion Destruction Billing
Our team bills actinic keratosis destruction with 17000, 17003 and 17004 by lesion count. Benign destruction uses 17110 for up to 14 lesions or 17111 for 15 or more, always as a single unit.
Dermatopathology Billing
We bill skin pathology at the correct level, using CPT 88305 for skin specimens and 88304 for cysts, tags, and debridements. Professional and technical components are split when the lab and reading physician differ. Practices running an in-office lab also need a current CLIA certificate on file.
Cosmetic Dermatology Billing
Medicare does not cover cosmetic skin surgery, so patients should hear the cost before treatment. When a patient asks us to submit anyway, we report modifier GY with Z41.1. When Medicare may deny a service as not medically necessary, we confirm a signed ABN is on file first.
Where Does Transcure Offer Dermatology Medical Billing Services?
Transcure offers dermatology medical billing services to practices across the U.S., with offices in Florida, Texas, and New Jersey. Practices looking for medical billing dermatology teams can rely on our remote billers, who work each state’s Medicaid rules and commercial payer mix:
Which CPT, HCPCS and ICD-10 Codes Does Our Dermatology Medical Billing and Coding Team Handle?
Our dermatology medical billing and coding team works every code family in the specialty, from office visits to Mohs. Each code below carries a counting, size, unit, or pathology rule. Our medical coding services apply those rules before a claim leaves the practice:
99202 to 99215
- Office visits, with modifier 25 when the E/M is separately identifiable from a same-day procedure.
11102 to 11107
- Tangential, punch and incisional skin biopsy, coded by method.
11400 to 11446, 11600 to 11646
- Excision of benign and malignant lesions, including margins.
17000 to 17004, 17110, 17111
- Destruction of actinic keratoses and benign lesions by lesion count.
17311 to 17315
- Mohs micrographic surgery by site, stage and tissue block.
88304, 88305
- Surgical pathology for skin specimens.
J3300, J3301
- Triamcinolone acetonide for intralesional injection (11900, 11901), billed per 1 mg or per 10 mg.
L57.0, L82.1, D22.-, C43.-, C44.-
- Actinic keratosis, seborrheic keratosis, melanocytic nevi, melanoma and other malignant neoplasms of skin.
L20.-, L40.-, L70.-
- Atopic dermatitis, psoriasis and acne.
How Does Transcure Compare for Dermatology Billing Outsourcing?
This comparison shows where Transcure differs from general vendors on dermatology billing outsourcing. Practices weighing dermatology billing companies can use the table to check coding ownership, pricing, and support:
| Feature | Transcure | Other Dermatology Billing Vendors |
|---|---|---|
| Dermatology-Specific Billing | Lesion, Mohs, pathology and cosmetic coverage expertise | General or multi-specialty billing focus |
| Coding and Billing Together | One team codes and bills, catching errors before submission | Billing only, with coding errors passed through |
| Modifier 25 Defense | Same-day visit documentation checked before billing | Modifier appended without a documentation check |
| Cosmetic and Medical Separation | Cosmetic services kept off insurance claims and A/R | Mixed ledgers that blur collection rates |
| AI-Powered RCM | Seven AI agents across the revenue cycle | Manual or partly automated processes |
| Account Management | Assigned dermatology account manager with a 2-hour response | Shared support queues |
| Pricing | Fixed fee at 5% of collections | Typically 6%–10% for full RCM |
Why Should You Outsource Dermatology Billing Services to Transcure?
Outsourcing dermatology billing frees clinic hours for patients while certified coders handle lesion counts, Mohs units, and payer rules. These six reasons explain why practices outsource dermatology billing services to Transcure, part of our full range of medical billing services:
Assigned Dermatology Account Manager
One account manager oversees your coding, payer follow-up, and denials, and responds within 2 hours.
Credentialing for Dermatologists and PAs
We enroll dermatologists, Mohs surgeons, PAs, and NPs through CAQH, PECOS, and payer portals, typically within 60 days.
Live Revenue Dashboard
The Master Command Dashboard shows live first-pass rates, A/R days, denial trends, and collections for your practice.
Lower Audit Exposure
Claims follow MAC coverage policies and NCCI edits, lowering risk on same-day visits, Mohs units, and benign lesion removals.
Fixed 5% Pricing
One flat fee of 5% of collections covers end-to-end RCM, credentialing and old A/R recovery.
Onboarding in Under 14 Days
Practices move to Transcure in under 14 days, with old A/R recovery included from the start.
How Do We Protect Your Dermatology Revenue From Modifier 25 Cuts and Audits?
CMS finalized a cut to same-day E/M payments starting January 1, 2027. It applies when an office visit billed with modifier 25 falls on the same day as a 0-day global procedure. Medicare then pays the higher-paid service in full and the other at 80%. Biopsies and Mohs carry 0-day globals, so those same-day combinations take the reduction. Destructions and excisions carry 10-day globals and fall outside it. CMS had proposed a 50% cut covering 10- and 90-day procedures too, then narrowed it in the final rule.
Scrutiny is rising alongside the cut. In November 2025, OIG estimated $62.9 million in Medicare overpayments to dermatologists for same-day E/M services that did not meet requirements. Blue Cross Blue Shield of Michigan planned a 50% modifier 25 cut for May 2026, then paused it.
Transcure protects your revenue by documenting every modifier 25 visit to withstand OIG review. We capture every lesion, unit, and repair the chart supports, and we prepare audit packages before a contractor asks. Our team also models the 2027 reduction against your same-day visit mix before January.
Which EHRs Do Our Dermatology Billing Solutions Work In?
Our dermatology billing solutions run inside every major EHR and practice management system, including dermatology-built platforms. We bill from your current system and if you plan a change, we recommend the option that fits your workflow and payer mix.
What Certifications Back Our Dermatology Billing Team?
Transcure’s dermatology billing team holds AAPC coding credentials, and the company is ISO 27001 certified. Transcure signs a BAA with every client and follows OIG compliance guidance for third-party billing companies.
How Dermatology and Skin Care Practices Rate Our Billing Services
Hear from dermatology, aesthetic, and specialty practices about what changed after their billing moved to Transcure.
Dermatologist
Medspa Dermatology, FL
“Our med spa and dermatology services used to blur together in billing, and insurance claims suffered. Transcure separated cosmetic and medical work, and our Florida dermatology claims now pay cleanly.”
Plastic Surgeon
AmjadPlastics, FL
“Excision and repair claims kept coming back underpaid because closures were not coded. Transcure fixed our documentation flow, and reconstructive claims at our West Miami practice now pay in full.”
CEO/Chief Medical Officer
Revive Community Health, AZ
“Debridement and skin substitute claims were stuck in denials and our A/R kept climbing. Transcure took over follow-up and appeals, and our wound care collections are finally steady.”
How Do Practices Rate Transcure on Review Platforms?
Practices that work with Transcure share their experience on Google, GoodFirms and Trustpilot.
Frequently Asked Questions About Dermatology Billing
These answers cover the questions dermatology practices ask most about billing, coverage, and pricing.
What is dermatology billing?
Dermatology billing is how a skin practice gets paid for visits, biopsies, excisions, destructions, Mohs surgery, and pathology. Derm medical billing depends on lesion counts, sizes, and margins, so documentation decides payment.
Why do dermatology claims get denied?
The leading causes of dermatology denials are unsupported modifier 25 visits and benign removals without a documented qualifying sign. Wrong biopsy code combinations, missed unit rules, and excisions billed before pathology also get denied.
When should a practice hire a dermatology billing service?
A practice should hire a dermatology billing service when A/R keeps aging, denials repeat, or staff cannot keep pace with coding rules. Practices also outsource when they add Mohs surgery, an in-office lab, or more PAs.
Does Medicare pay for cosmetic dermatology procedures?
Medicare does not pay for cosmetic dermatology procedures. Benign lesion removal is covered only when the record documents a qualifying sign, such as bleeding, pain, or recent change. Patients pay for purely cosmetic work.
What is Transcure's dermatology billing service pricing?
Transcure’s dermatology billing service pricing is a fixed 5% of monthly collections. The fee covers end-to-end RCM, credentialing, and old A/R recovery, and you pay only when Transcure collects.
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