Cardiology Medical Billing Services in Pennsylvania
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, 92920-92944 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.
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 (92943-92944), and global-period overlaps.
Why Pennsylvania cardiology practices choose AMS
- 33+ years handling Medicare billing across all 8 MAC jurisdictions including Novitas
- 95%+ clean claim rate on first submission, vs 85-90% industry average
- 100% U.S.-based billing team — no offshoring, all PHI stays domestic
- HIPAA-compliant with full BAA, encrypted data exchange, role-based access
- 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%.
Ready to talk? Call (214) 571-6317 or book a free 30-minute review with our team. We’ll audit a sample of your Pennsylvania cardiology claims at no cost.