# Nephrology Billing Services | Dialysis & ESRD Medical Billing | PRMS

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Nephrology Billing

# Nephrology Medical Billing Services

Nephrology billing runs on the monthly capitation payment model for dialysis, a system unlike any other specialty. Our certified coders specialize in nephrology and ESRD so your dialysis and clinic revenue is captured in full.

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We handle nephrology billing end to end, dialysis MCP billing, ESRD care, home dialysis, and inpatient nephrology. Because dialysis reimbursement uses age-based monthly capitation codes with visit requirements, a specialty-trained team is what prevents the denials and lost revenue unique to the field.

## Nephrology billing we handle

- **Dialysis MCP codes.** Monthly capitation payment (90957 to 90970) by age and visit count.
- **ESRD management.** End-stage renal disease care coded to visit and complexity requirements.
- **Home dialysis.** Home and self-care dialysis billing.
- **Inpatient nephrology.** Hospital visits and consults with correct E/M.
- **AKI & inpatient dialysis.** Hospital and acute dialysis (90935 to 90947) for non-ESRD and acute kidney injury.
- **Kidney transplant management.** Transplant evaluation and post-transplant care coding.
- **Renal biopsy & procedures.** Kidney biopsy and related procedures where performed.
- **Vascular access & procedures.** Access-related procedures where performed.
- **CKD clinic visits.** Chronic kidney disease office E/M and management.

**The MCP visit rule.** Monthly capitation dialysis codes depend on the patient's age *and* the number of face-to-face visits in the month. Bill the wrong tier for the visit count and the claim is denied or underpaid, a common nephrology error we prevent.

## Why nephrology practices lose revenue

The usual losses: wrong MCP code for age/visit count, missed visits affecting the capitation tier, CKD clinic visits under-coded, and inpatient consults billed incorrectly. Nephrology-trained coders apply the dialysis rules correctly.

## What you get with PRMS

### MCP expertise

Monthly capitation dialysis codes billed to the correct age and visit tier.

### ESRD accuracy

End-stage renal care coded to meet visit and complexity requirements.

### Full capture

Home dialysis, CKD clinic, and inpatient care all billed.

## Nephrology billing FAQs

**How is dialysis billed in nephrology?

Outpatient dialysis is billed with monthly capitation payment (MCP) codes (90957 to 90970) that vary by the patient's age and the number of face-to-face visits that month. Correct tier selection is essential to full, compliant payment.

**Do you handle home dialysis and ESRD?

Yes, home and self-care dialysis billing and end-stage renal disease management, coded to the applicable visit and complexity requirements.

**Can you bill inpatient nephrology consults?

Yes, with correct E/M leveling for hospital visits and consults alongside outpatient dialysis and CKD management.

**How soon will results show?

Most nephrology practices see cleaner dialysis MCP claims and fewer tier-related denials within the first one to two billing cycles.

## Related services & specialties

Explore our full [billing, coding & denial management services](https://prmsbs.com/services) and [provider credentialing](https://prmsbs.com/medical-credentialing/), or see other specialties including [25+ more](https://prmsbs.com/specialties/).