Hospitals & In-Patient Care Teams

Expert Revenue Cycle Management for Hospital-Based & ICU Pulmonary Services

Hospital-based pulmonary and critical care services operate in one of the most regulated and high-risk billing environments in healthcare. Inpatient care, ICU services, and critical care billing demand precise documentation, strict adherence to time-based coding rules, and continuous alignment with Medicare and payer policies.

Hospital-based pulmonary and critical care services operate in one of the most regulated and high-risk billing environments in healthcare. Inpatient care, ICU services, and critical care billing demand precise documentation, strict adherence to time-based coding rules, and continuous alignment with Medicare and payer policies.

Specialized Support for High-Acuity In-Patient & ICU Care

We support pulmonary physicians, intensivists, hospitalists, and hospital-employed providers delivering high-acuity care in inpatient units and intensive care settings. Our team understands the clinical intensity, documentation complexity, and billing sensitivity associated with critical care medicine.

By aligning provider documentation with payer requirements, PulmoCare RCM ensures that every billable service is captured accurately, coded correctly, and submitted compliantly—reducing revenue leakage and audit risk.

Why Pulmocare RCM for Critical Care Coding?

27+

27 years of Pulmonary & Critical Care billing experience

Specialty-trained ICU coding professionals

US

Nationwide U.S. coverage

CMS

Deep CMS & payer guideline expertise

AI

AI-enabled documentation audits

📊

Transparent reporting and analytics

Proven denial reduction strategies

In-Patient & Critical Care Services We Support

PulmoCare RCM delivers comprehensive RCM coverage for hospital-based pulmonary and critical care services, including:

Initial & Subsequent Hospital Care Billing

Accurate coding for initial inpatient services, subsequent hospital visits, and discharge management in compliance with CMS and payer rules.

Critical Care Billing (CPT 99291 & 99292)

Precise time-based coding with thorough documentation review to ensure medical necessity, qualifying activities, and compliant time aggregation.

ICU Documentation Review & Compliance Validation

Detailed review of ICU notes to confirm time thresholds, service separation, and avoidance of overlapping or non-billable activities.

Ventilator Management & Pulmonary Procedures

Correct coding and billing for ventilator management, respiratory support, and pulmonary procedures performed in inpatient and ICU settings.

Consult Services & Cross-Coverage Billing

Support for consult services and multi-provider coverage models while ensuring proper attribution and compliance.

Split/Shared Visit Compliance

Strict adherence to evolving CMS and payer guidelines for split/shared visits involving physicians and advanced practice providers (APPs).

Our Hospital RCM Advantage

Hospitals and in-patient care teams choose PulmoCare RCM for our specialty-driven, compliance-first approach to revenue cycle management.

Deep Expertise in Medicare & Medicare Advantage Billing

Extensive knowledge of inpatient billing rules, MA plan variations, and payer-specific documentation requirements.

Accurate Time-Based & Complexity-Driven Coding

Expertise in both time-based critical care coding and medical decision-making models for inpatient services.

Reduced Compliance Risk & Audit Exposure

Proactive documentation review and policy alignment to protect against audits, recoupments, and payer disputes.

Improved Turnaround Time & Clean Claim Rates

Streamlined workflows, clean claim submissions, and disciplined follow-ups to accelerate reimbursement cycles.

A True Extension of Your Hospital Revenue Team

PulmoCare RCM functions as a trusted extension of your hospital’s revenue cycle and compliance teams. We provide transparency, accountability, and measurable outcomes — allowing hospitals to focus on patient care while maintaining strong financial and regulatory performance.

PulmoCare RCM delivers precision, compliance, and results for hospital-based pulmonary and critical care services.

Turn Pulmonary Complexity into Predictable Revenue

Pulmonary billing doesn’t have to be complicated or unpredictable. With PulmoCare RCM, pulmonary physician groups gain a trusted RCM partner who understands their specialty, protects their compliance, and maximizes their revenue potential.

PulmoCare RCM turns pulmonary complexity into predictable, sustainable revenue — so your physicians can focus on delivering exceptional patient care.

Critical Care Coding FAQs

What qualifies as critical care for billing purposes?

Critical care qualifies when a physician provides direct care to a patient with life-threatening or organ-failure conditions requiring constant attention, supported by detailed documentation and time tracking.

How do you bill for critical care time accurately?

Critical care is billed using time-based CPT codes. We validate documented time, remove bundled procedures, ensure no overlap between providers, and confirm medical necessity before claim submission.

What causes critical care billing denials most often?

Common causes include missing time statements, insufficient documentation, overlapping provider time, incorrect bundling, and lack of medical necessity documentation.

Do you handle pulmonary physicians who also provide critical care?

Yes. We specialize in pulmonary-critical care overlap and ensure pulmonary services and critical care services are coded separately and compliantly.

Can Pulmocare RCM work with ICU teams and hospitalists?

Yes. We support ICU physicians, hospitalists, pulmonary-critical care specialists, and inpatient care teams nationwide.

How fast are critical care claims submitted?

Most critical care claims are submitted within 24–48 hours after complete documentation is received.

Is Pulmocare RCM HIPAA compliant?

Yes. We follow strict HIPAA standards, including encrypted data handling, role-based access, secure systems, and regular audits.

Can critical care coding outsourcing increase revenue?

Yes. Practices typically see 20–40% revenue improvement by preventing underbilling, reducing denials, and ensuring compliant time-based billing.

Schedule a Demo / Contact Us

Let us show you how our Pulmonary & Critical Care Billing expertise can transform your revenue performance.