Medical billing and revenue cycle management for US healthcare providers
Pediatric Billing That Keeps Families and Practices Happy
Every minute your team spends on billing is a minute taken from patient care. Well-child visits, vaccines and screenings billed correctly, so families and practices both win. MedRexon helps you cut denials, speed up payments and keep reporting simple, so you can focus on your patients.
- Medical Coding
- Billing Audit
- Credentialing
- Denial Management
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Personalized Billing for Pediatrics Services
Every pediatrics practice is different, and so are its billing challenges. MedRexon builds a billing process around your setup, whether you run one location or several. We check eligibility early, send clean claims quickly, follow up on every denial and report results clearly. Our team knows the codes and rules that matter most in pediatrics billing, including 99381 – 99385 and 99391 – 99395.
Billing Audit
Clear Reports
Pricing for Your Practice
What makes Pediatrics billing different
Preventive care comes first
Well-child visits use age-based codes and are often covered at no cost to families.
Vaccine rules
Vaccines include a product and an administration, with special rules for state-supplied vaccines.
Mixed visits
A child may come for a check-up and also have a sick concern at the same visit.
Codes you will use most
A quick reference for the services providers in pediatrics bill most often.
| CODE | WHAT IT IS | GOOD TO KNOW |
|---|---|---|
| 99381 – 99385 | New patient preventive visit | By age group |
| 99391 – 99395 | Established patient preventive visit | By age group |
| 90460 / 90461 | Vaccine administration with counseling | By patient age and component |
| 90471 – 90474 | Vaccine administration without counseling | Used by some payers |
| 96110 | Developmental screening | Includes scoring and documentation |
| 96127 | Brief emotional or behavioral assessment | Per scored tool |
| SL modifier | State-supplied vaccine | Bill administration only for free state vaccines |
General education only. Codes, rules and payer policies change. Always check current AMA CPT, CMS and payer guidance.
Top denial reasons and how to prevent them
Preventive and sick visit together
Fix: Bill the sick visit with modifier 25 only when it is a separate problem.
State vaccines billed as product
Fix: Bill only the administration, with the right modifier, for free state vaccines.
Age or frequency mismatch
Fix: Check the age category and payer frequency rules.
Screenings bundled
Fix: Document the tool used, the score and the result for each screening.
Provider checklist
- Verify coverage and the preventive schedule
- Use the correct age-based preventive code
- Record vaccine lot, site and counseling
- Separate sick-visit work with modifier 25
- Document the screening tool, score and follow-up plan
- Check state vaccine program rules
Quick win for Pediatrics
Developmental and behavioral screenings are often missed at well visits. A quick checklist at check-in captures work you already do.
We take the billing work off your plate
Accurate coding
Coding reviewed against current rules for pediatrics.
Clean, fast claims
Claims checked before they go out, so fewer come back.
Denial recovery
We find the cause, appeal and prevent repeats.
Clear reports
Monthly numbers you can read in minutes.
Pediatrics billing questions
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