Family physicians can get paid for common services such as counseling and screenings. The key is recognizing them and knowing how to code them.
This is a corrected version of the article that appeared in print.
Fam Pract Manag. 2025;32(4):26-32
Author disclosure: no relevant financial relationships.
Primary care physicians often provide more care than the evaluation and management (E/M) services they typically bill for,1 but many are not familiar enough with the additional services to document and bill for them.
The most common missed opportunities in primary care involve counseling or preventive services, but there are other billable services physicians may be missing out on as well. Once you recognize these services, the key to preventing denials is understanding what diagnosis codes and documentation payers require. Then, you can link the diagnosis codes to the CPT codes in the EHR and make templates to streamline the documentation process.
This article covers several CPT and HCPCS codes for services family physicians often provide but less commonly bill.
KEY POINTS
Services such as tobacco cessation counseling and intensive behavioral therapy for obesity are appropriate for many patients and can be billed separately from evaluation and management.
The key to avoiding insurance denials when billing these services is knowing which diagnosis codes to use and how to document your work.
While the relative value units tied to some of these services may be small, they can add up quickly, and in many cases primary care physicians may already be doing the work and just not billing for it.
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