Optimize your revenue cycle with expert rheumatology billing services designed for biologic therapies, infusion administration, and complex specialty coding.
Our AI-assisted claim review and team of AAPC-certified rheumatology billing specialists help practices achieve 98.5%+ first-pass claim rates and recover up to 20% in lost revenue, based on performance data across 200+ rheumatology and infusion billing accounts
First-Pass Rate
Denial Reduction
Billing Accounts
The Problem
High denial rates for infusion therapy & biologic drugs
Lost revenue due to missed CPT codes and documentation errors
Complex payer-specific requirements slowing reimbursements
Time-consuming prior authorizations and claim follow-ups
Critical Revenue Area
Avoid automatic denials due to wrong codes.
Capture unbilled wastage and recover revenue.
Ensure first-line medication failure is properly documented to accelerate payer approval.
Properly bill evaluation services during infusion visits.
Our Services
Verify patient insurance coverage, copay responsibility, and infusion authorization requirements to avoid eligibility-related denials.
Precise rheumatology CPT codes, ICD-10, and HCPCS coding for autoimmune conditions, joint injections, biologic drugs, and infusion therapy services.
Expert handling of Remicade, Actemra, Orencia, Humira, Cimzia, including NDC linkage and JW modifiers.
Advanced claim review processes identify coding errors before submission to maintain 95%+ first-pass claim acceptance rates.
Systematic identification and correction of denied claims with payer-specific appeal documentation to recover lost revenue efficiently.
Accurate recording of payer reimbursements and adjustments to maintain transparent financial tracking.
Active monitoring of unpaid claims to keep receivable cycles within 20–30 days and prevent aging balances.
Full management of prior authorization workflows including payer documentation, Step Therapy verification, and approval tracking.
All claims are validated against ACR guidelines and payer LCDs to ensure medical necessity.
Transparent dashboards and performance reports that help physicians monitor collections, denials, and payer trends.
Specialization Matters
Rheumatology billing is highly specialized. Here’s why a dedicated rheumatology billing company is essential:
Results That Matter
Collection Ratio
Net Collection Rate
First Clean Claim Pass Rate
Denial Rate
Revenue Increase
Turnaround Time
A/R Reduction
Overhead Reduction
Choose Your Plan
Transparent Pricing with no hidden Cost
Starter
For Solo & Small Practices
of collections
Most Popular
Growth
For Group Practices & Clinics
of collections
Enterprise
Hospitals & Large Systems
Volume-based pricing
Our Expertise
50+ EHR/EMR/PMS
Coding Reference
Rheumatology billing in 2026 requires a thorough understanding of the latest CPT codes, HCPCS drug codes, infusion administration rules, and payer documentation requirements. Our coding specialists continuously monitor updates to ensure accurate claim submission.
Coding Reference
| CPT Code | Procedure | Critical Modifiers |
|---|---|---|
| 99214 | Established patient office visit | -25 |
| 20610 | Arthrocentesis or joint injection | -RT, -LT |
| 96413 | IV infusion administration, first hour | -59 |
| 96415 | Each additional infusion hour | -59 |
| 96365 | Therapeutic IV infusion, first hour | -59 |
| 96366 | Each additional infusion hour | -59 |
| 96372 | Therapeutic injection (IM/SubQ) | -59 |
| 96401 | Subcutaneous therapy administration | -59 |
| 36415 | Venipuncture | -59 |
| 85652 | ESR test | -QW |
| 77080 | Bone density scan (DXA) | -26 |
J-Codes
| J-Code | Medication / Drug |
|---|---|
| J0129 | Abatacept (Orencia) |
| J0717 | Certolizumab pegol (Cimzia) |
| J3262 | Tocilizumab (Actemra) |
| J1030 | Methylprednisolone acetate |
| J1200 | Diphenhydramine hydrochloride |
| J0702 | Betamethasone |
Avoid Costly Mistakes
| Billing Challenge | Impact on Practice | Our Solution |
|---|---|---|
| Infusion Time Miscoding | Delayed or denied claims | Accurate tracking and correct CPT application |
| Drug Wastage Not Billed | Lost revenue | Verification of dosage, NDC, and wastage modifiers |
| Modifier Errors | Partial payments | Correct modifier application and quarterly updates |
| Documentation Gaps | Increased denials | Chart review against ACR and payer standards |
| Prior Authorization Failures | Payment delays | Full management of pre-approvals and Step Therapy |
| Staffing Gaps | Billing delays | Dedicated rheumatology billing specialists |
All rheumatology billing workflows are HIPAA-compliant, ACR-aligned, and audit-ready.
Specialization Matters
Experts monitor these changes so your practice never misses reimbursement opportunities.
Our Advantage
Dastify Solutions delivers rheumatology-focused revenue cycle management that ensures accurate coding, faster reimbursements, and reduced denials. Here’s what sets us apart from generic billing providers:
Trusted by Leading Rheumatology Practices Nationwide
Common Questions
Ready to Scale
Our rheumatology billing company includes AAPC-certified coders with specialty training in infusion therapy billing, J-code accuracy, and ACR documentation standards.We help practices reduce denials, accelerate reimbursements, and strengthen revenue cycle performance.
