Urgent Care Billing Services for Increased Revenue
- Stop losing revenue to payer downcoding of your urgent care Evaluation & Management claims.
- Expert billing ensures compliant capture of all state-specific facility and modifier fees (POS 20).
- Maximize collections from high walk-in volume with instant eligibility verification and faster A/R.
- Achieve an industry-leading 98%+ clean claim rate to minimize denials and speed up payment.
Why Does Your Practice Need Urgent Care Billing Services?
The High-Volume Trap: Overwhelmed staff miss critical verification steps for walk-ins, leading to massive revenue leakage and denials.
E/M Code Downcoding: Payers frequently reduce billed Evaluation and Management (E/M) service levels, which directly slashes revenue per visit.
POS 20 & Facility Fee Confusion: Complex and varying state rules for POS 20 and facility fee billing create costly rejection backlogs and compliance risks.
Slow Cash Flow: High patient volume requires rapid reimbursement, so waiting 60+ days for acute care claims severely restricts practice scaling.
How Transcure’s Medical Billing Services Handle Urgent Care Pain Points
Transcure understands these billing pitfalls clearly and offers personalized medical billing and coding solutions for your Urgent Care practice. We offer these services:
Maximum Reimbursement
Our certified coders specialize in urgent care E/M documentation to fight downcoding, leading to an average 99% clean claim rate.
24/7/365 Eligibility Verification
We pre-verify every walk-in patient, minimizing bad debt and capturing the correct copay/deductible at the Point-of-Service.
50-State Regulatory Expertise
As a national provider, we guarantee compliance with all regulations and payer rules governing urgent care facility fees and ‘incident-to’ billing.
Accelerated RCM Cycle
Our streamlined workflow reduces your Accounts Receivable (AR) days by up to 30%, ensuring your practice gets paid faster than the industry average.
Comprehensive Urgent Care Billing and Coding Coverage for Different Procedures
Transcure expertly navigates the unique billing and coding requirements for all common urgent care services, including:
E/M Services
Our experts accurately code the appropriate E/M level (e.g., 99203-99215) for each visit, based on medical decision making and time spent. This prevents downcoding and ensures you're reimbursed correctly for patient acuity and complexity, crucial for high-volume urgent care.
Minor Procedure Billing
We specialize in billing for procedures like stitches (laceration repair), foreign body removal, or abscess drainage. Accurate coding includes proper CPT codes, modifiers (e.g., -25 for separate E/M), and documentation to capture all services performed compliantly.
Diagnostic Imaging
Urgent care often involves in-house X-rays for fractures or foreign objects. We ensure correct CPT codes for the specific views taken, proper use of professional and technical components, and necessary documentation to support the medical necessity for each imaging study.
Lab Services
For common urgent care lab tests like rapid strep, flu, or urinalysis, we handle precise coding and billing. This includes correct CPT codes, knowing when to bill as point-of-care vs. send-out, and adhering to payer-specific rules for lab services performed in an urgent care setting.
Injections & Vaccinations
Billing for injections or vaccinations requires separate coding for the administration (CPT 96372) and the medication itself. Our team ensures proper documentation of the drug, dosage, and route, along with accurate CPT codes and modifiers for each.
Diagnostic Imaging Billing
A critical component of urgent care revenue. We ensure your claims accurately reflect the Point of Service (POS) code 20 and correctly apply any eligible facility fees or incident-to billing rules specific to the payer and state, optimizing reimbursement for your overhead.
Nationwide Coverage of Urgent Care Billing Services by Transcure
Transcure’s presence in all 50 states across the U.S. makes it the ideal choice for practices to outsource urgent care billing services. Our mission to provide affordable medical billing solutions is evident from our presence in the following states:
Our Expertise in Handling CPT and ICD-10 Codes for Urgent Care Center Medical Billing
While working with Transcure, you can rest assured about regulatory compliance and code changes. Our 1100+ AAPC-certified billers and coders stay updated with Urgent Care regulatory and CMS changes. Our expertise lies in all urgent care billing codes, including:
99214
- Office visit (Established Patient)
99204
- Office visit (New Patient)
12002
- Simple repair of superficial wounds
10060
- Incision and drainage of an abscess
87880
- Rapid Strep A Test
J02.9
- Acute pharyngitis, unspecified
N39.0
- Urinary tract infection (UTI)
R50.9
- Fever, unspecified
S93.409A
- Sprain of unspecified ankle ligament
How Outsourced Urgent Care Billing Services Help Practices Save Money
In-House Urgent Care Billing
The calculations are done for small to medium-sized urgent care practices.
Annual Salary: $25000 to $35000
Overhead Cost: $15000 to $25000
Downsides
Not Cost-Efficient
Less Skilled Billers
Lacks Automation
Cost of Outsourcing to Transcure
The calculations are done for the practices earning around $100000 per year.
Transcure’s Rate: 5% on average
Total Amount: Approximately $5000
Upsides
Save up to $45000 annually
Team of over 1100 skilled billers
RPA-powered Billing
Enhanced Revenue with Transcure’s Emergency Billing Services
Emergency Services handle critical, life-threatening trauma and illness 24/7. Their billing uses higher-level CPT codes and facility fees (POS 22) that are significantly more complex and scrutinized. Accurate triage documentation is important for justifying high-level reimbursement to avoid massive denials.
Transcure’s AAPC-certified teams eliminate compliance risks by mastering the distinct coding rules for each setting. We ensure urgent care gets maximum return on volume while hospital-affiliated practices secure appropriate reimbursement for highly complex emergency department cases.
Our Success in Numbers
Value of claims processed
Accounts Receivable Days
Turn Around Time (TAT)
Customer Retention
Number of Claims Processed
First Pass Clean Claims Rate
Revenue Improvement
Reduction in A/R
Transcure’s Onboarding Process for Urgent Care Billing and Coding
Our simple onboarding process makes it easier and quicker to outsource urgent care coding and billing to us. The following steps explain everything you will go through during the onboarding process:
Welcome Call
Our partnership starts with a meeting to discuss our workflow and set clear goals.
Implementation Questionnaire
We collect all the required data to adjust our services to your specific needs.
Onboarding Meeting
Transcure’s team securely accesses your EHR and billing platforms for a smooth integration.
Establishing Workflow SOPs
We finalize a customized plan that details every step of your billing cycle.
Go-Live DateSOPs
Your service officially begins, with our team managing your complete RCM.
One Fits All EHR Integration for Urgent Care Billing
Our team masters oncology‑specific modules in the following EHRs to ensure error-free emergency billing and coding.
Empowering Urgent Care Practices to Succeed Financially
Read our partners’ success stories to recognize the worth of our urgent care services.
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)
How are urgent care services billed differently from primary care and emergency room visits?
Urgent care uses specific S codes (like S9083 and S9088) along with standard Evaluation and Management (E/M) CPT codes, distinguishing its claims from primary care or ER services. Billing also considers the higher costs and walk-in nature of urgent care visits.
What are the most common CPT and HCPCS codes for urgent care?
Typical codes include 99202–99205 for new patients, 99212–99215 for established patients, and S codes like S9083 (global fee) and S9088 (urgent care service add-on).
How does insurance coverage work at urgent care centers?
Most urgent care centers accept a wide range of insurance plans, but coverage and patient responsibility (copay, deductible) depend on individual policies and may differ from other provider types.
How do urgent care billing services verify insurance and determine copays?
Billing staff verify eligibility at check-in and confirm the patient’s copay or deductible, facilitating prompt payment and avoiding coverage issues.
How does time-based billing work in urgent care?
Certain E/M services can be billed according to the total face-to-face time spent with the patient, which requires precise documentation of the duration and type of service provided.
