Quick answer
AMS Solutions provides neurology medical billing services for independent neurology practices and groups: EEG and long-term EEG monitoring, EMG and nerve conduction studies, Botox for chronic migraine, infusions and E/M, with prior authorization and denial follow-up.
“We take care of you, so you can take care of your patients.” Since 1992, AMS Solutions has handled medical billing for neurology and neurosurgery practices across the United States. We’re a dedicated team with AAPC-certified coders, and we sign a BAA for covered services. We know neurology coding inside and out, from EMG and nerve conduction study professional and technical splits to chronic migraine chemodenervation and infusion drug units. This page walks through how AMS handles neurology billing and revenue cycle management services, the procedures and modifiers we work with daily, and what to expect when you partner with us. Practices in specific states can also see our pages for neurology medical billing in California and neurology medical billing in New York.
Every AMS client is assigned a dedicated billing team led by an Account Manager you can reach directly: no call centers, no phone trees, no handoffs between strangers. Your team is built specifically for neurology coding nuances and the EMR/EHR you already use (Epic, NextGen, eClinicalWorks, athenahealth, and others).
Neurology claims are denial-prone for structural reasons: pro/tech component splits on EMG and EEG, dense modifier rules around E&M-with-procedure bundling, payer-specific prior authorization on chronic migraine injections and infusion drugs, and ongoing LCD compliance pressure. We have specific operational depth in each.
EMG/NCS is the highest-volume neurology procedure, and the professional vs. technical component split (modifier -26 and -TC) is where most claims get denied. Key codes we work daily (for a deeper walkthrough, see our EMG and EEG billing guide):
Long-term and ambulatory EEG monitoring has expanded under newer CPT codes, and payers are aggressive about technical-component documentation:
OnabotulinumtoxinA for chronic migraine is one of the most denial-prone procedures in neurology because of (1) PA requirements with payer-specific clinical criteria, (2) the J-code drug bill that often gets miscoded as the procedure code, and (3) the strict 12-week interval requirement:
IVIG, anti-CD20 monoclonal antibodies, natalizumab, and other infused biologics for MS, myasthenia gravis, and CIDP carry both high reimbursement and high denial risk. We handle:
Neurology PAs cover OnabotulinumtoxinA, infusions, advanced imaging (MRI brain with contrast, MRI spine), implanted devices (DBS, VNS, RNS), and selected EMG/NCS combinations. We submit and track PAs as part of the same workflow that submits the claim, not as an afterthought, with payer-specific submission rules we update each quarter.
| Service | What we handle | Codes |
|---|---|---|
| EEG | Routine EEG recorded awake and drowsy or awake and asleep, with professional and technical component billing and diagnosis linkage for medical necessity | 95816, 95819 |
| Long-term EEG monitoring | Setup and takedown, technical monitoring and physician review, billed by recording duration and by whether video is captured | 95700 (setup), 95720 (professional review with video) |
| EMG and nerve conduction studies | Needle EMG add-on codes reported with same-day nerve conduction studies, the nerve conduction study code selected by the total number of studies, and professional and technical component splits | 95886, 95910 and the other nerve conduction study codes |
| Chemodenervation for chronic migraine | Prior authorization, 12-week interval tracking, and drug units and wastage documentation. 64615 is inherently bilateral; J0585 is 1 unit of onabotulinumtoxinA per billing unit | 64615 + J0585 |
| Infusions | IV administration billed by time, drug J-code units reconciled to the dose given, and prior authorization for biologics | 96365, 96366 |
| Office E/M | New and established office visits coded on medical decision making or total time, with modifier 25 when a separately identifiable visit accompanies a procedure | 99204, 99214 |
Many neurology practices also run sleep diagnostics, and those claims follow their own coverage, documentation and prior authorization rules. In-lab polysomnography, titration studies and home sleep testing each carry separate professional and technical component considerations, and a combined neurology and sleep visit needs documentation that supports every service billed. We run sleep claims as a distinct workflow alongside neurology, so the component split, the referring order and the authorization are in place before the claim goes out.
CPT codes 95800, 95801 and 95806 are deleted effective 1 January 2027 and remain valid through 31 December 2026. See our guide to the 2027 home sleep test code changes, or learn more about our sleep medicine billing services.
The codes that cause the most trouble are the needle EMG add-on codes. 95885 (limited study), 95886 (complete study), and 95887 (non-extremity/cranial) are add-on codes reported per extremity or region, not per muscle, and they cannot be billed independently of a nerve conduction study performed the same day. When NCS is not performed on the same date, you bill the legacy codes 95860, 95861, 95863, or 95864 instead. Getting this wrong is one of the fastest routes to an automatic denial.
Neurology ICD-10 codes demand specificity. For headache disorders alone, the coder must distinguish between migraine with aura (G43.1), migraine without aura (G43.0), chronic migraine (G43.7), and tension-type headache (G44.2). Epilepsy codes require the seizure type and whether the condition is intractable (G40.x1) or not intractable (G40.x0).
A common billing error is using an unspecified diagnosis code when a more specific code exists. Payers increasingly reject claims with unspecified codes when clinical documentation supports a precise diagnosis. Linking the correct ICD-10 code to the CPT code is essential; the diagnosis must justify the procedure for the claim to be reimbursed.
Many neurology patients require long-term care for chronic conditions like epilepsy, multiple sclerosis, or Parkinson’s disease. For these patients, documenting medical necessity is an ongoing process, not a one-time task. Each follow-up note must justify the continued need for care by detailing the patient’s current status, response to treatment, and any new or changing symptoms. Payers will look for this narrative to approve claims for ongoing management. Simply stating “follow-up for MS” is not enough. Your documentation should reflect the complex decision-making involved in managing these conditions over time, which is a cornerstone of effective practice management and essential for avoiding claim denials for long-term services.
Where you see your patients matters just as much as the care you provide. Billing for services performed in a hospital setting is fundamentally different from billing for those done in your private clinic. In a hospital, billing is often split: the hospital submits a claim for the facility fee and equipment use (the technical component), while you bill for your professional expertise and interpretation (the professional component, using modifier 26). In your own clinic, you typically bill for both components together as a global service. Clear documentation is your best friend here. Your notes must always support the medical necessity of the service, regardless of the location. Getting this distinction right is a core part of effective practice management that prevents payment delays and ensures you are properly reimbursed for your work.
Beyond outright denials, a more subtle threat to your practice’s revenue is the underpayment. This happens when a payer reimburses you less than the amount stipulated in your contract. Identifying these discrepancies requires a meticulous payment posting process. When an ERA or EOB comes in, your team must compare the allowed amount for each CPT code against your contracted fee schedule. Don’t just accept the payment and write off the difference as a contractual adjustment. Investigating these shortfalls is critical for understanding your practice’s true financial performance and holding payers accountable for their agreed-upon rates.
Common reasons for underpayments include the payer applying an outdated fee schedule, incorrectly bundling services that should be paid separately, or miscalculating patient responsibility. To challenge an underpayment, you must file an appeal that includes a copy of the EOB and the relevant section of your payer contract highlighting the correct fee. This level of detailed follow-up is where having a dedicated medical billing service can make a significant difference, as they have the resources and expertise to challenge every underpaid dollar, ensuring your practice collects the full reimbursement it has earned.
This KPI measures how much it costs your practice to collect the money you’re owed. It’s a measure of efficiency, calculated by dividing your total billing costs (including staff salaries, software fees, and clearinghouse charges) by the total amount of money collected. A high cost to collect can silently drain your profitability, even if your overall revenue seems strong. Tracking this metric helps you understand the true financial impact of claim denials, lengthy A/R follow-up, and inefficient workflows. Accurate payment posting is foundational, as it gives your practice a clear view of its financial KPIs and helps you determine if your current billing process is cost-effective or if it’s time to explore a more specialized solution.
Beyond specific procedure and diagnosis codes, Evaluation and Management (E/M) codes are central to neurology billing. These codes reflect the complexity of your patient encounters, focusing on the level of Medical Decision Making (MDM) involved. Think of MDM as the measure of how complex your thought process was during the visit: how many diagnoses you considered, the amount of data you reviewed, and the risk involved in the treatment plan. In neurology, where patient cases are often intricate, accurately capturing the correct E/M level is essential for fair reimbursement. Your documentation is the evidence that supports the level you choose. Without detailed notes justifying your MDM, you risk downcoding and losing revenue, or worse, facing an audit. This is where meticulous record-keeping becomes the backbone of your financial health.
You can’t improve what you don’t measure. Tracking Key Performance Indicators (KPIs) gives you a clear view of your billing department’s health and helps you spot problems early. Focus on metrics like your clean claims rate (the percentage of claims accepted on the first submission), your claim denial rate, and the average number of days in accounts receivable (A/R). A sudden spike in denials or a growing A/R balance can signal an underlying issue that needs immediate attention.
Monitoring these numbers allows you to move from being reactive to proactive. When you see a problem, you can dig into the data to find the root cause, whether it’s a recurring coding error or delays with a specific insurer. Using experts to ensure claims are coded correctly and submitted on time is crucial. They can also work to resolve rejected claims quickly so your practice gets paid for its hard work.
Tele-neurology has become a game-changer, allowing you to connect with patients no matter where they are. It’s an incredible tool for expanding access to care, but it also brings its own set of billing challenges. The rules for virtual appointments are different from in-person visits, and payers have specific requirements you must meet to get reimbursed. This includes getting patient consent, documenting the virtual platform you used, and ensuring the service itself is even approved for telehealth delivery. Without a clear process for managing these details, you risk claim denials that can disrupt your revenue stream. A knowledgeable billing partner can help you handle these rules, ensuring your telehealth services are a financial success, not a compliance headache.
One of the most critical details in tele-neurology billing is using the correct Place of Service (POS) code. This simple two-digit code tells the payer where the service happened, and getting it wrong is a surefire way to get a claim rejected. For telehealth, you’ll typically use POS code 02 if the patient is at a location like another clinic, or POS code 10 if they are in their home. These distinctions matter immensely to insurance companies. A generic billing approach might overlook this detail, but a specialized team understands that this precision is non-negotiable for clean claims. This is just one example of how deep neurology billing expertise prevents denials and keeps your practice’s revenue cycle healthy.
We work the full neurology code set every day, including the EMG and nerve conduction study codes, the EEG codes, the sleep study codes, the evoked potential codes, the autonomic function testing codes, lumbar puncture 62270, and the chronic migraine chemodenervation code 64615 with its onabotulinumtoxinA drug code J0585. Our coders know which procedures bundle, which modifiers are required, and how each payer handles pro/tech splits.
EMG and nerve conduction studies routinely split between professional (modifier 26) and technical (TC) components, and the rules differ by place of service and equipment ownership. We track who’s reading the study, who owns the equipment, and bill professional vs. global vs. technical accordingly. We also ensure the correct CPT pairing (e.g. 95910 vs. 95911 vs. 95912 based on nerve count) because miscoding this is one of the most common sources of neurology underpayment.
Yes. Chronic migraine OnabotulinumtoxinA is one of the most prior-auth-intensive billable services in neurology. We handle the J0585 units (1 billing unit per unit of drug), the 64615 administration code (inherently bilateral, reported once per session), the required prior auth and step therapy documentation, and the 12-week re-auth cycle. We also track NDC reporting and AbbVie copay assistance where applicable.
Neurology has one of the highest prior auth burdens in medicine: OnabotulinumtoxinA, MRI/MRA, IVIG, monoclonal antibodies for migraine (CGRP), and many EP and sleep studies require auth. We track each payer’s requirements, file the request with supporting clinical, follow up until you have a number, and confirm the auth is attached to the claim before submission.
Onboarding time depends on your EHR, payer setup and provider enrollment status. We handle the EHR/PM integration (Epic, NextGen, eClinicalWorks, athenahealth, and others), payer setup, fee schedule load, and provider enrollment review. Your practice keeps seeing patients without disruption during the transition.
Yes. Signed BAA for covered services.
Start with a Free Billing Analysis. Send us your aging A/R, three months of receivables, and three months of billables. We return written findings on your clean claim rate, denial breakdown by category and days in AR by payer. Findings in 5 Business Days. No commitment, no obligation.
AMS Solutions provides specialty-specific medical billing across neurology and the practices that share neurology’s prior auth complexity and high denial environment. Explore our other specialty billing pages:
If you’re considering switching billing partners, or moving from in-house to outsourced for the first time, start with a Free Billing Analysis. You’ll receive written findings covering your clean claim rate, denial breakdown by category and days in AR by payer. Findings in 5 Business Days. The analysis is yours whether you hire us or not.
EEG, EMG/NCS, OnabotulinumtoxinA for chronic migraine, and the prior-auth gauntlet codes neurology billing teams need at their fingertips. Save it for your team.
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