Independent neurology practices got hit hard this year. Medicare slashed payments 2.83% in January. Demand for neurologists jumped 73% while the workforce can’t keep up.
But here’s what most practices miss: you don’t need more patients. You need to actually collect what you’re already earning.
The Financial Reality
Medicare reimbursements fell 29% since 2001 when you adjust for inflation. The 2025 conversion factor sits at $32.35.
Neurology got squeezed harder than most. Demand exceeds supply by 19%. New patients wait 35 business days. Over half of neurologists report burnout, and many retire early.
Why Neurology Takes the Hit
EEGs, EMGs, nerve conduction studies—these need time-based coding where one missing detail costs thousands.
The denial problem:
- 35% of neurology claims get denied initially
- Denial rates run 20-30% (double most specialties)
- 52% of denials happen from documentation gaps
- Claims sit 20-40% longer than other specialties
Specialty practices deal with headaches primary care never touches.
Where Your Money Disappears
Coding Mess
Time-based billing for EEG monitoring trips up practices constantly. Bill a 60-minute EEG the same as 24-hour monitoring? You just lost money. Miss the right modifier on EMG with nerve conduction? Denied.
Prior Authorization Pitfalls
Advanced imaging, botox for migraines, most specialized diagnostics—they all need prior authorization. Skip it or lose track? Payer denies the claim even though you already treated the patient.
Here’s the kicker: 40% of denied neurology claims never get touched again. Staff would rather write them off than spend $25-35 reworking each one.
| Denial Type | What Causes It | How to Fix It |
| Medical Necessity | Weak documentation | Link symptoms to diagnosis |
| Time Documentation | Missing times | Automated tracking |
| Modifier Errors | Wrong modifiers | Pre-submission review |
| Authorization | Missing prior auth | Systematic tracking |
Missing Telehealth Money
CMS made telehealth permanent for neurology in 2026. Cognitive assessments, follow-ups, even audio-only consultations now qualify. Better yet, reimbursement jumped 15-20%.
Most practices haven’t figured out how to bill this correctly yet.
What Actually Works
Clean Claims = Fast Money
Shoot for 95%+ clean claim rate. Get claims right the first time, money comes faster, staff stops wasting time on rework.
You need scrubbing software that catches neurology-specific screw-ups, real-time eligibility checks before you schedule procedures, and medical coding validation by people who actually understand neurological procedures.
Specialized medical billing services help catch these errors before they go out. Most practices see improvement within 90 days.
Documentation That Payers Accept
Your notes need to prove why you ordered that expensive MRI or EMG.
For EEG billing: write down exact start/stop times, what the patient came in for, what type of monitoring you did, what you found.
For EMG and nerve conduction: how many studies you ran, which nerves you tested, why you tested them, how the findings match your diagnosis codes.
Track What Matters
Monthly reviews show you where the money is. Clean claim rate by procedure, payment speed for EEG vs EMG, prior auth approval rate, denials by payer and CPT code, A/R days for diagnostics.
Neurology-Specific Money Makers
Maximizing Telehealth Revenue
Permanent coverage now includes cognitive assessments, follow-ups, audio-only consultations, remote EEG monitoring. Code these right. The right tools help track what qualifies.
Bill Diagnostics Correctly
EEG procedures pay well when billed right. Routine vs extended monitoring codes—they’re different.
EMG with nerve conduction studies? Document every nerve tested, use right unit codes, slap on correct modifiers or watch bundling denials pile up.
Chronic Care Programs
Epilepsy, MS, Parkinson’s patients need ongoing care. Set up systematic protocols, document properly, bill correctly—recurring revenue.
Stop Wasting Physician Time
Neurologists shouldn’t burn hours wrestling with prior auth systems. You’re too valuable for that, especially with burnout hitting 53% and patients waiting over a month to see you.
Get help with neurology billing when denials top 15%, A/R drags past 40 days, or 2026 billing changes make your head spin.
Billing partners who know neurology understand which EEG codes need what documentation and how payers handle nerve conduction studies differently.
Need Help with Neurology Billing?
Book a free consultation to simplify your billing, speed up reimbursements, and cut down denials.
TALK TO AN EXPERTDon’t Cut Corners
Don’t upcode. Don’t bill for tests patients didn’t need. Don’t fudge time documentation. Don’t ignore medical necessity rules.
Do capture services you actually provided. Do document with clinical justification. Do stay current with neurology CPT and ICD-10 updates. Do run internal audits on your riskiest procedures.
Payers audit neurology hard. Your documentation better back up every claim.
Warning Signs Your Billing Workflow Is Failing
Denials stay above 15%. A/R ages past 40 days. Prior auth delays hurt patient care. Staff drowns in specialty coding requirements.
Ask partners: Done EEG billing before? What’s your EMG coding accuracy? What’s your denial recovery rate? Can I talk to your neurology clients?
Where You Should Be
| Metric | Target | Where Most Practices Sit |
| Clean Claims | 95%+ | 80-85% |
| Days in A/R | 35-40 | 50-60 |
| Denials | Under 10% | 20-30% |
Small Fixes Pay Off
Month 1: tighten EEG documentation, cut denials 5%. Month 2: fix telehealth coding, add $15K monthly. Month 3: correct modifier usage, drop denials another 3%. Month 4: track prior auth systematically, approve 15% more procedures.
Practice doing $1.8M yearly? These changes put an extra $90K in your pocket.
Start Here
Pull your last 90 days of EEG and EMG claims. Figure out your denial rate by procedure. Look at your prior auth tracking. Fix your worst problem first.
Independent neurology practices can make it work despite the workforce shortage. The ones pulling it off nail their specialty billing, watch their numbers like hawks, and partner with people who get neurological coding.
See where your billing’s bleeding money? Talk to us about a free look at your practice.