Pennsylvania Cardiology Billing Expertise
AMS Solutions provides specialized cardiology medical billing for practices across Pennsylvania. From Philadelphia to Pittsburgh and the rest of the state, our AAPC-certified billers handle the full cardiology code set (93451-93461 catheterization, 92920/92924/92928/92930/92933/92937/92941/92943/92945 PCI, 93306-93308 echo, 93619-93655 EP) and the prior authorization for advanced imaging (CT coronary angiography, cardiac MRI, PET) and structural-heart procedures (TAVR, MitraClip) that Pennsylvania practices need to navigate.
CPT 2026 change (effective 1 January 2026): 92921, 92925, 92929, 92934, 92938 and 92944 were deleted. Branch work is now included in the base code for that major coronary artery, 92930 covers two or more distinct lesions with two or more stents in two or more segments or a bifurcation lesion treated in both the main artery and the side branch, and 92945 covers a chronic total occlusion treated by combined antegrade and retrograde approaches.
Pennsylvania-specific payer landscape
We work with Pennsylvania Medical Assistance (administered through DHS, including HealthChoices MCOs), plus all major commercial plans: Highmark, Independence Blue Cross, Aetna, UnitedHealthcare, Geisinger Health Plan, UPMC Health Plan. Pennsylvania operates under Novitas Solutions as the Medicare Administrative Contractor. Pennsylvania uses Novitas for Medicare with active LCD updates on cardiac imaging and EP studies.
Cardiology services we bill
Our cardiology billing team handles PCI/cath lab procedures, echocardiography, electrophysiology studies, nuclear cardiology, and cardiac CT/MRI. We’re particularly strong at managing the common modifier 26/TC splits, CTO PCI documentation (92943 and 92945), and global-period overlaps.
Why Pennsylvania cardiology practices choose AMS
- Since 1992, handling Medicare billing across all 8 MAC jurisdictions including Novitas
- 95%+ clean claim rate on first submission, vs 85-90% industry average
- Signed BAA for covered services
- AAPC-certified coders: every chart is reviewed by a CPC, COC, or CRC
Frequently asked questions
Yes — every plan listed in administered through DHS, including HealthChoices MCOs. We verify benefits before each billing cycle.
We work with all in-state Medicare Advantage plans, commercial plans, and Medicaid MCOs. We verify benefits and authorizations before each catheterization or imaging study.
We track payer-specific bundling rules and apply correct modifiers (26 professional, TC technical, 76 repeat) at the time of charge entry. Our denial rate on cardiology cases is under 5%.
Learn more about our cardiology billing services and full revenue cycle management.
Performance depends on payer mix, documentation, workflows, and engagement scope; individual results vary.
Ready to find revenue-cycle gaps? Call 866-973-2221 or request a free medical billing audit.