Medical Billing Solutions for Healthcare Providers
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Medical Billing Solutions for Healthcare Providers
Accurate medical coding services nationwide.
Reliable Credentialing Enrollment Across…
Verify patient insurance coverage, benefits…
Tracking payments, invoicing , managing…
Improve collections by insurance claim denials.
Reliable, accurate, compliant, friendly billing…
Efficient support with our Virtual Assistant services
Grow your brand, we handle your social media.
Boost your website traffic with expert SEO
Interactive e-learning to boost skills anytime, anywhere.
Get noticed online with Google Ads.
Manage patient records securely with EHR solutions.
Assisted Living Billing Services by Revex Square is where you turn whether you're a physician group visiting residents in assisted living or the facility itself billing residents for their care, not to work out whether a visit belongs under place of service 12 or 13, or which level-of-care tier a resident's invoice should reflect this month. Physician-side billing in assisted living runs on its own E/M code family and non-facility payment rate. Facility-side billing runs on private-pay room-and-board charges, care-level tiers, and ancillary services. Getting either one wrong either denies a clean claim or quietly underbills a resident's family. That's where assisted living billing services from Revex Square come in.
Practices and facilities get paid faster, cleanly, and predictably by engaging a billing partner that actually understands both sides of assisted living billing, not a generalist team applying nursing-home or home-health billing logic to a setting that follows neither rule set exactly. No long meetings. No jargon-heavy reports. Just a partner who understands assisted living billing completely, from a single Medicare visit to full facility resident invoicing.
Imagine finishing your month knowing that every physician visit is coded to the correct place of service, every resident's invoice reflects their actual care level, and every claim or bill is already moving through the payment stream instead of sitting in a denial or dispute. That's the peace we bring to assisted living billing every day.
Complete billing & RCM overview for physician groups and assisted living facilities
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Schedule a Free DemoWe handle the billing so you can focus on your residents.
Focused, specialty-trained medical billing experience helping healthcare organizations improve collections and protect revenue.
Our billing team focuses on accurate claim submission, catching the small errors that turn into big denials before they ever reach a payer.
We follow every claim from submission through payment, so your organization sees revenue faster and keeps a steadier cash flow.
Our team understands POS 13 billing, the 2023 domiciliary code elimination, care-level resident billing, and the unique challenges of assisted living revenue cycle management.
We simplify every step of your revenue cycle, whether you bill Medicare or bill residents directly.
For physician groups, we confirm patient eligibility and enrollment status. For facilities, we confirm the resident's current care-level agreement and any applicable Medicaid waiver authorization.
Our team captures every billable encounter — physician E/M visits with their correct place of service, or facility charges including base rate, care-level add-ons, and ancillary services.
Certified billers assign the correct Home or Residence Services E/M code (99341–99345 or 99347–99350) with POS 13 for physician claims, or apply the correct level-of-care tier and ancillary charge codes for facility resident invoices.
Clean physician claims are submitted electronically to Medicare, Medicare Advantage, and commercial payers. Resident invoices are generated and submitted to families, responsible parties, or state Medicaid waiver programs on schedule.
We monitor payments, follow up on unpaid claims or overdue resident balances, and aggressively manage denials, disputes, and outstanding accounts.
Every E/M code, place of service, and care-level charge is carefully reviewed to reduce coding errors, claim rejections, resident billing disputes, and lost revenue.
Our streamlined billing workflow helps move claims and invoices through the revenue cycle and improves your cash flow.
Comprehensive revenue cycle solutions designed for both sides of assisted living billing — including the gaps most billing companies skip.
Since the 2023 elimination of the old domiciliary and rest-home codes (99324–99337), assisted living visits are billed using the Home or Residence Services code family (99341–99345, 99347–99350) with place of service 13. Many practices still default to outdated codes or the wrong POS — we keep coding current with the active code set.
POS 13 is paid at Medicare's non-facility rate, typically higher than a facility rate for the same CPT code, because the practitioner — not an institution — bears the practice expense. Miscoding a visit under a facility POS quietly underpays the claim; we make sure that never happens.
Assisted living residents with multiple chronic conditions are frequently eligible for Chronic Care Management or Transitional Care Management on top of the visit itself. We identify and bill this frequently missed revenue when documentation and time requirements are met.
For the facility side, we manage private-pay resident invoicing, including base room-and-board charges, care-level tier adjustments as a resident's needs change, and one-time or recurring ancillary charges.
Assisted living pricing is typically tiered to a resident's assessed care needs. We help track and bill tier changes accurately so a resident's invoice reflects their current care level, not an outdated assessment.
In states offering Medicaid waiver support for assisted living, billing that portion of a resident's care runs on entirely different authorization and unit rules than private-pay billing. We manage waiver billing separately so it isn't blended incorrectly into private-pay invoices.
Our team identifies the root cause of denials on the physician side and billing disputes on the facility side, corrects the underlying issue, and follows up to recover the revenue.
We monitor outstanding physician claims and resident balances, prioritize aging accounts, and actively follow up to accelerate collection.
Detailed reports and performance insights help physician groups and facility operators understand collections, denials or disputes, A/R, and the overall health of their revenue cycle.
Let Revex Square handle your billing while you focus on residents.
Every organization billing in assisted living is different. A physician group visiting residents across several communities has different billing needs than a single assisted living facility invoicing residents directly, or a multi-site senior living operator managing both private-pay and Medicaid waiver residents at once.
Revex Square provides specialized assisted living billing solutions designed around a setting that follows neither standard physician-office rules nor nursing-facility rules exactly. Assisted living billing depends on knowing which code family applies since the 2023 domiciliary code change, how the non-facility rate affects reimbursement, and how private-pay, care-tier, and Medicaid waiver charges are billed differently — details that most other specialties never deal with.
Accurate Home or Residence Services E/M coding for physician visits, and correct care-level and ancillary coding for facility resident billing.
Experienced handling of Medicare, Medicare Advantage, commercial payers, state Medicaid ALF waivers, and private-pay resident and family billing.
From eligibility or care-level verification to coding, claims or invoices, denials or disputes, and A/R follow-up, covering the full path from encounter to final payment.
Your organization deserves more than a general medical billing company. You need a revenue cycle partner that understands both sides of assisted living billing.
Our billing professionals understand POS 13 coding, the current Home or Residence Services code family, care-level resident billing, and the compliance requirements that make assisted living billing fundamentally different from office, home health, or nursing facility billing.
Simple, transparent pricing with no unnecessary hidden fees, allowing you to understand exactly what you are paying for.
Work with experienced billing specialists who become an extension of your practice or facility and remain focused on your financial performance.
From registration and eligibility or care-level verification to coding, claims or invoices, denials, and A/R follow-up, we manage the complete cycle.
From claim denials to resident billing disputes, Revex Square helps identify the problems affecting your revenue and provides practical solutions.
Practices still billing the deleted 99324–99337 domiciliary codes see automatic rejections under current CMS rules.
Billing an assisted living visit under a facility POS instead of POS 13 quietly underpays the claim by applying the wrong fee-schedule rate.
Chronic Care Management and Transitional Care Management opportunities are frequently missed for eligible assisted living residents.
Invoicing a resident at an outdated care tier after their needs have changed creates disputes and underbilling.
Mixing Medicaid ALF waiver charges into standard private-pay invoices creates compliance and reconciliation problems.
We prioritize aging physician claims and resident balances, maintaining consistent follow-up to keep accounts receivable under control.
Let our assisted living billing experts identify opportunities to improve your revenue cycle.
Answers to common questions about assisted living medical billing, CPT codes, place of service, Medicare, Medicaid, and revenue cycle management.
Since January 1, 2023, physician visits to residents in assisted living are billed using the Home or Residence Services code family: 99341, 99342, 99344, and 99345 for new patients, and 99347 through 99350 for established patients. The older domiciliary and rest-home codes (99324–99337) were eliminated and are no longer valid.
Place of Service (POS) 13 is used for assisted living facility visits. It is distinct from POS 12, which is used for the patient's home, and is treated as a non-facility setting under Medicare, meaning it is paid at the applicable non-facility rate.
ALF medical billing generally refers to physician, nurse practitioner, or physician assistant services delivered to residents living in an assisted living facility. These services are billed to Medicare Part B under the Home or Residence Services codes and are separate from the facility's room-and-board and residential care charges.
Many CPT codes have separate Medicare payment rates for facility and non-facility settings. POS 13 is treated as a non-facility setting, so using the correct place of service is important because incorrect POS reporting can affect claim processing and reimbursement.
Yes, when all applicable documentation, eligibility, and time requirements are satisfied, a practitioner may be able to bill Chronic Care Management (CCM) or Transitional Care Management (TCM) in addition to an eligible evaluation and management service. Each service must meet its own Medicare billing requirements.
Skilled nursing and nursing facility visits use their own nursing facility evaluation and management code families and different place-of-service codes. Assisted living services use the Home or Residence Services code family with POS 13. Because the coding and reimbursement rules differ, the setting must be identified correctly before claims are submitted.
Facility-side billing is generally based on private-pay arrangements, which may include a base room-and-board rate, care-level charges based on the resident's assessed needs, and additional ancillary services. This facility billing is separate from Medicare claims submitted by physicians or other healthcare providers.
In many states, Medicaid offers Home and Community-Based Services (HCBS) waiver programs that may help eligible residents pay for certain assisted living or supportive services. Availability, covered services, eligibility requirements, and billing rules vary significantly by state.
Yes. Revex Square can support the assisted living billing workflow, including eligibility verification, coding, claim submission, payment posting, denial and dispute management, accounts receivable follow-up, and reporting. Facility-side resident billing can also be addressed based on the organization's specific needs.
Revex Square's assisted living physician billing services can start at 2.75% of monthly collections, while facility resident billing may be quoted separately based on resident volume and billing complexity. Pricing is confirmed during a consultation so the scope of services and applicable fees are clear before work begins.