At Mastermind Healthcare RCM Tactics, we specialize in pediatric-specific revenue challenges— from well-child visit coding (CPT® 99381–99394) to vaccine component billing (HCPCS 90471/90685) and Medicaid/CHIP eligibility verification. Our team recovers lost revenue from underbilled immunizations and prevents denials before they happen.
Expert use of CPT 99381–99394 for well-child visits and HCPCS 90471/90685 for vaccines with correct administration and component billing.
Full adherence to state-specific Medicaid rules, EPSDT screening requirements, and vaccine coverage policies to prevent denials.
We bill for every administered dose and recover revenue for unused vials using modifiers JW/JZ.
Real-time Medicaid/CHIP eligibility checks before visits to prevent claim rejections and patient billing surprises.
Monthly reports on missed well-visit codes, underbilled vaccines, and payer underpayments to recover lost revenue.
Work with coders who understand pediatric workflows, developmental screenings, and vaccine bundling rules.
Using E/M codes instead of preventive CPT 99381–99394 triggers 50–100% revenue loss for routine visits.
Failure to bill for vaccine components or administration leads to $20–$150 lost per immunization.