Pulmonology Billing Services: 5 Companies Compared, Plus 12 Questions to Test Them
By MedicalBillingSelect · Sources checked October 5, 2026
Pulmonology billing services are outside companies that send your claims and chase the money. Depending on the contract, that can cover office visits, pulmonary function tests (PFTs), hospital and ICU work, bronchoscopies, sleep studies, and pulmonary rehab. Several of the offers below use percentage-of-collections pricing.
We read the public pages of five of these companies on October 5, 2026. Two disclose a numerical billing percentage in those pages: ProMBS advertises a 2.49% starting rate for qualifying practices, and AdvancedMD lists a typical 4–8% of practice collections. We did not find a monthly minimum for any of the five in those sources.
So you have two jobs. Get every quote into the same dollars. And make each company prove it knows pulmonology. This page gives you a tool for each.
The company links on this page go to each company's own website. They are unpaid. How we make money.
Compare 5 pulmonology billing companies
Listed A to Z. This is not a ranking. A website can't tell us who bills best, so we don't pretend it can.
"Not published" means we did not find it on the company pages we read. It does not mean zero, and it does not mean the company lacks it.
| Company | Price it publishes | Monthly minimum | Software and EHR | Contract | Pulmonology page |
|---|---|---|---|---|---|
| ADS (ADSRCM) | Not published | Not published | Offers its own software. Also says you can keep your EHR through an interface. Source | Not published | Yes |
| AdvancedMD (managed billing) | Typical range of 4–8% of practice collections. Source | Not published | AdvancedMD software is included. Ask if you can keep another EHR | Advertises no long-term agreement. Confirm cancellation notice and exit charges. Source | Has pulmonology software pages. Its billing price page covers most specialties, not pulmonology alone |
| BellMedEx | Not published. Its pricing page asks for your contact details first. $0 setup. Source | Not published | Says it works inside your EHR. Lists Epic, athenahealth, eClinicalWorks, Kareo, DrChrono, ModMed, and NextGen | Month-to-month available; a longer term is optional. Confirm your proposal's notice and exit terms | Yes |
| Medwave | Custom quote. A percentage of all money collected. Source | Not published | Says you may use your own software | Not published | Yes, with credentialing. Source |
| ProMBS | Advertises starting at 2.49% of monthly collections for qualifying practices. Final pricing depends on volume, payer mix, and scope. Source | Not published | Says it usually works with existing EHR/PMS systems, subject to compatibility, access, permissions, and required functionality | Term, notice, and exit charges not published | Yes. Describes PFT, hospital/critical-care, procedure, sleep, denial, unpaid-claims, and credentialing support. Confirm your exact scope |
What this table tells you
- Two of five disclose a numerical billing percentage in the pages we reviewed. A starting rate is not a complete quote. Eligibility, included work, minimums, and other fees still need confirmation.
- We did not find a monthly minimum in those sources. Ask every one. A minimum plus other fees can turn a 3% quote into 4.5% in a slow month. The math is below.
- One explicitly offers month-to-month on its page. AdvancedMD separately advertises no long-term agreement. Ask every company how many days' notice you must give.
- AdvancedMD's price includes its software. That may suit a practice considering new software. If you want to retain your EHR, confirm the supported arrangement before shortlisting it.
What each company says about its own results
These are company claims, not independently verified, comparable results for your practice. Ask for the metric definition, relevant practice group, baseline, time period, and supporting report.
- ADS advertises an increase in revenue within 90 days, without explaining the guarantee's detailed terms on this page. It also reports nearly 99% success on first-attempt clearinghouse submissions. Clearinghouse acceptance is not the same as payment.
- BellMedEx reports 96% or better first-pass acceptance, 85% or better reversal on the appeals it pursues, and a start in 5 to 7 business days. It says it selects which appeals to pursue. Source.
- ProMBS's general services page claims a 98% reduction in denials and a 30% revenue increase. Those statements do not establish expected outcomes for a pulmonology practice. Source.
- AdvancedMD and Medwave: we did not find a numerical, pulmonology-specific performance result in the pages we reviewed.
Who to ask first
- Want billing and software from one company? Start with AdvancedMD or ADS.
- Want to keep your EHR? BellMedEx, Medwave, ADS, and ProMBS describe ways to do that. Make them confirm compatibility and show the arrangement for your exact system.
- Want a company that publicly advertises month-to-month terms? BellMedEx states it. Confirm the notice period and exit terms in your proposal.
- Want the lowest numerical starting rate disclosed in this comparison? ProMBS. Ask what it takes to qualify, and ask for the minimum.
- Need credentialing too? BellMedEx, Medwave, and ProMBS list it. Ask if it's in the fee. Medwave lists separate pricing structures for credentialing and payer contracting.
Before you fill out a contact form, grab the 12 questions. Send the same request to each company so you can compare the answers.
First, list what your practice actually bills
"Pulmonology" is not one kind of billing. A company can be good at office visits and weak at the line that makes your money.
Go down this list. Mark each line you bill. Then make every company say, in writing, whether that line is included, costs extra, or stays with your staff.
| If you bill this | Why it's tricky | The rule to know |
|---|---|---|
| Office visits and PFTs in your own lab | Test components and routine test-related assessment are included | For diagnostic bronchodilator-response testing, 94060 includes the pre/post spirometry and bronchodilator administration; do not add 94010 or 94640 for that work. The medication may be separately reportable. A documented, significant, separately identifiable E/M service may be reported with modifier 25. (CMS NCCI manual, Chapter XI) |
| PFT reads on hospital equipment | You bill only your part | If the PFT code allows a separately billed professional component, bill only your documented interpretation with modifier 26. Check the code's Medicare fee-schedule indicator. Do not bill the hospital's technical work. (CMS component explanation, Noridian modifier 26) |
| Hospital and ICU critical care | Time rules. And charges can get lost between the hospital and your office | For Medicare, 30–103 minutes of qualifying critical care supports 99291 once; the first 99292 begins at 104 minutes. Exclude time spent on separately reported procedures. Being in an ICU does not itself qualify the service. (Medicare contractor guide) |
| Sleep studies, home sleep tests, and CPAP follow-up | Testing and equipment coverage have separate requirements | Confirm which testing, interpretation, follow-up, and supplier tasks the vendor handles. Medicare initially covers qualifying CPAP therapy for 12 weeks. Continued device coverage requires documented benefit and adherence, including a practitioner reevaluation during days 31–91 after therapy starts. (CMS CPAP policy, PAP coverage requirements) |
| Pulmonary rehab | Session counts | Medicare limits covered programs to two one-hour sessions daily and 36 sessions over up to 36 weeks. Another 36 sessions may be covered with Medicare Administrative Contractor (MAC) approval; medically necessary sessions 37–72 require KX. The patient and program must also meet coverage requirements. (42 CFR 410.47, CMS claims manual, §140.4) |
| Lung cancer screening visits | The patient must qualify first | Medicare's low-dose CT (LDCT) screening criteria include age 50–77, no lung-cancer signs or symptoms, at least 20 pack-years, current smoking or quitting within 15 years, and an LDCT order. Before the first screening, the patient needs a documented counseling and shared-decision visit. (CMS screening policy) |
| Home oxygen orders | Ordering and equipment billing are different jobs | If you only order oxygen, the supplier bills the equipment. If your practice also operates a supplier, confirm that separate billing scope. Medicare stopped accepting oxygen certificates of medical necessity (CMNs) for dates of service on or after January 1, 2023; orders and supporting medical records still matter. (CMS notice, Medicare oxygen coverage) |
| Bronchoscopy, biologics, remote monitoring | Several codes in one visit. Prior approval. Monthly time logs | No single rule. Ask if each one is in the base fee or extra |
These examples use Medicare rules. Other payers can differ. Ask which rule the company applies to each payer and service date.
Employed by a hospital? If the hospital bills under its own tax ID, you probably aren't the one choosing a billing company. This page is for practices that bill under their own.
The Proof Test: 12 questions to send before a demo
Pulmonology experience is easy to claim. You can't see inside a billing company. Neither can we. These questions are the next best thing.
Send them before the sales call. Ask for specific answers and current sources. A team may need details about your documentation, setting, and payers; those questions are part of a useful answer.
Eight questions with specific billing rules
| # | Ask this | A good answer sounds like |
|---|---|---|
| 1 | For diagnostic bronchodilator-response testing, we do spirometry, give a bronchodilator, and repeat the test. What do you bill? | "94060 includes the pre/post spirometry and bronchodilator administration. We do not add 94010 or 94640 for that work. The medication may be separately reportable." |
| 2 | When can we report an office visit alongside PFTs? | "For a documented, significant, separately identifiable E/M service beyond the test-related work, with modifier 25. A quick check just for the test does not qualify, and the modifier does not guarantee payment." |
| 3 | We read PFTs done on hospital equipment. What goes on our claim? | "The documented professional interpretation, using modifier 26 only if the specific PFT code permits that split. We verify the Medicare fee-schedule indicator and do not bill the hospital's technical work." |
| 4 | A Medicare patient got 80 minutes of critical care. What do you bill? | "99291 once, assuming 80 minutes of documented qualifying critical care. We exclude separately reported procedure time. Medicare's first 99292 begins at 104 minutes; we check other payers' rules." |
| 5 | Our physician and NP in the same group share a Medicare critical-care visit in a facility on the same day. Who bills? | "The practitioner who provides more than half the combined qualifying critical-care time bills, with FS. We count joint time only once, document each practitioner's time, and have the billing practitioner sign and date the record." |
| 6 | A Medicare patient is on pulmonary rehab session 37. What changes? | "We check prior sessions, continued medical necessity, and the MAC's requirements for additional sessions. Medically necessary sessions 37–72 need KX; a modifier alone does not establish coverage." |
| 7 | How do you check G0296 and first-LDCT requirements? | "Screening requires age 50–77, no lung-cancer signs or symptoms, at least 20 pack-years, current smoking or quitting within 15 years, and an LDCT order. For G0296, we check documented counseling before the first scan: a decision aid, annual-screening adherence, comorbidities and ability or willingness to undergo diagnosis and treatment, plus smoking-cessation or continued-abstinence counseling." |
| 8 | We order home oxygen for a Medicare patient. What form do you send? | "No CMN for Medicare dates of service on or after January 1, 2023. The order and supporting medical records still have to meet coverage requirements." |
These examples use Medicare rules, linked above. The CMS critical-care and split/shared rules support question 5; the CMS preventive-services manual covers G0296. A sound answer should state the conditions and explain what documentation or payer checks are still needed.
Four questions about how they work
| # | Ask this | Why it matters |
|---|---|---|
| 9 | Send a synthetic or de-identified sample monthly report split by service line: office, PFT, sleep, hospital. | A service-line split helps you see where money leaks |
| 10 | How do you get our hospital and ICU charges each day? | A missed hospital charge never becomes a claim |
| 11 | Who handles prior approval for sleep studies and biologics? Is it in your fee? | Settle ownership and the fee before the first authorization |
| 12 | If Medicare rates drop in 2027 and our collections fall, does your minimum fall too? | A percentage shrinks when your revenue shrinks. A minimum does not |
On question 12: Medicare's Physician Fee Schedule uses service values, geographic adjustments, and a dollar multiplier called the conversion factor. The 2026 factors, rounded to cents, are $33.57 for qualifying alternative payment model participants and $33.40 for other clinicians. CMS proposed 2027 factors of $33.17 and $32.84, respectively, on July 14, 2026. The 2027 rule was still proposed as of October 5, 2026. The effect on your practice also depends on which services you bill. (2026 final rule; 2027 proposed rule)
There's no pass mark. Put the answers side by side. If a company stays vague on questions 1 through 8 after you supply the missing details, ask for a billing specialist before moving forward.
Copy the whole request
This has the 12 questions plus the scope list and the fee questions. Copy it into an email or a contact form, then fill in the top.
Leave out patient names and claim details. Totals are enough for a quote.
What pulmonology billing services cost, and how to compare quotes
The short answer: the reviewed pages provide two numerical billing-price references: AdvancedMD's general 4–8% range and ProMBS's qualifying 2.49% starting rate. ADS, BellMedEx, and Medwave did not disclose an ongoing billing percentage in those sources.
Don't read that as "pulmonology billing costs 2.49% to 8%." Those are different offers with different fine print. Your real cost depends on three things the headline number hides.
1. What the percentage applies to. All the money you collect? Insurance payments only? Only what the billing company itself collects? Four percent of $80,000 is $3,200. Four percent of $100,000 is $4,000. Same rate, $800 apart.
2. The monthly minimum. In a slow month, you pay the minimum even if the percentage would be less.
3. Everything else. Software, clearinghouse fees, patient statements, setup.
Put each quote into the tool the same way. Then compare dollars, not percentages.
Quote Leveler
The example below is filled in. Change any number, or clear it and enter your own quotes. The calculation runs in your browser; this tool has no submission step.
| Quote | Monthly cost | Share of collections | First-year cost | Slow month |
|---|---|---|---|---|
| Quote A | $3,000 | 3.33% | $36,000 | $1,800 (4.50%) The minimum applies. |
| Quote B | $3,825 | 4.25% | $45,900 | $1,700 (4.25%) |
| Quote C | $3,600 | 4.00% | $45,200 | $1,600 (4.00%) |
- Quote A: the percentage fee reaches the minimum at about $50,000 a month in total collections.
- Quote B: no minimum, nothing left blank.
- Quote C: no minimum, nothing left blank.
- Quote B costs $825 a month more than Quote A. It evens out if it collects about $862 more a month (0.96% of your collections).
- Quote C costs $600 a month more than Quote A. It evens out if it collects about $625 more a month (0.69% of your collections).
This is arithmetic on the numbers you enter. It is not a quote, and it does not predict what any company will collect. Setup charges are in the first-year cost only. Extra-collections comparisons assume the same insurance share and service scope. This tool supports a flat rate on all collections or insurance collections only, with the minimum applied to the percentage fee and other monthly charges added afterward. It does not model tiered rates or a fee on only the money a vendor collects; ask for an invoice on a comparable fee base.
A worked example
These three quotes are made up. They are not any company's prices. The practice collects $90,000 a month, and 85% of that comes from insurance.
| Quote A | Quote B | Quote C | |
|---|---|---|---|
| Rate | 3% | 5% | 4% |
| Applies to | All collections | Insurance only | All collections |
| Monthly minimum | $1,500 | None | None |
| Other monthly charges | $300 | $0 | $0 |
| Setup | $0 | $0 | $2,000 |
| Monthly cost | $3,000 | $3,825 | $3,600 |
| Share of collections | 3.33% | 4.25% | 4.00% |
| First-year cost | $36,000 | $45,900 | $45,200 |
| A slow month at $40,000 | $1,800 (4.50%) | $1,700 (4.25%) | $1,600 (4.00%) |
Three things to notice.
The "3%" quote isn't 3%. With the $300 software charge, Quote A costs 3.33% in a normal month.
In a slow month, the cheapest quote becomes the most expensive. Say a physician is out and collections drop to $40,000. Three percent would be $1,200. But the minimum is $1,500. Add $300 and Quote A costs $1,800, which is 4.50%. Its percentage fee reaches the minimum at $50,000 a month in collections.
A small collection difference can outweigh the fee gap. Quote B costs $825 a month more than Quote A. That gap is covered if B collects about $862 more a month, after its fee on the extra collections. That's under 1% of the example's $90,000. Quote C needs about $625 more. These are monthly break-even amounts, assuming the same 85% insurance mix and service scope; they exclude setup, including Quote C's $2,000. They do not predict what a company will collect. This is why the Proof Test matters alongside the rate.
How the tool does the math: it takes the larger of your percentage fee and the minimum, then adds the other monthly charges. First-year cost is twelve of those months plus setup, assuming collections and charges stay the same. It supports a flat percentage on all collections or insurance collections only. For tiered pricing or a fee on only the money a vendor collects, ask for a comparable sample invoice.
If you leave a cost blank, the tool uses $0 as a lower bound and labels the affected totals "At least." Quotes with an unknown minimum or other monthly charges are excluded from monthly price-gap comparisons. Unknown is not zero. Get the real number in writing.
Want to see how one published minimum plays out? Our homepage walks through Recoup's outpatient mental-health offer: 3% with a $1,000 monthly minimum. It illustrates fee mechanics; it is not a pulmonology offer.
Five things to get in writing before you sign
- What the fee applies to. Check copays your front desk collects. Does the company take a cut of those?
- The monthly minimum. The amount, and exactly when it applies.
- Your old unpaid claims. Who works the claims from before the switch, and is the rate different? Get that fee separately.
- Your data. You should be able to see your claims the whole time. And you should get a full export if you leave.
- How you leave. Days of notice, any exit charge, and who finishes the claims already sent.
A billing vendor handling protected health information for a HIPAA-covered practice is a business associate. Have the required written business associate agreement in place before sharing records. A "HIPAA compliant" badge alone does not establish how a company's safeguards were assessed. (HHS guidance)
More on how we read contracts and minimums is in our methodology.
How to protect cash flow when you switch
A start date doesn't tell you when the money gets steady. BellMedEx says it starts in 5 to 7 business days. That is its claim, and it is about starting, not about cash.
Settle these in order:
- Before you sign: scope, fees, system access, the business associate agreement, and exit terms.
- Before the start date: who owns visits from before that date, old unpaid claims, open appeals, pending approvals, and payments not yet posted.
- On the start date: check provider and location lists, payer logins, and who posts payments.
- After the first month: match visits to claims sent and to payments received. Ask for a list of what's still open, with a name next to each item.
- Arrange continued access or a usable export of your old records until open claims, appeals, payments, and refunds are reconciled. Agree on access length and cost before the switch.
Should you outsource at all?
Not always.
Keep billing in-house if your biller knows PFT and sleep rules and your denials are low. You may only need better software or a backup person. See what to check when your team keeps the billing.
Outsource if your biller left, hospital charges keep getting missed, or nobody is working denials.
Split it if office billing is fine and one area is the mess, like sleep or old unpaid claims. Ask each company if it will take just that piece.
Questions practices ask
Do pulmonology practices pay a higher rate than other specialties?
We did not establish an unconditional, all-in pulmonology price for any offer. AdvancedMD's range covers most specialties. ProMBS publishes a qualifying starting rate on its pulmonology page. Ask each company how your hospital, ICU, testing, and other required work affects the quote.
We're one or two physicians. Will they take us?
BellMedEx explicitly names solo and small-group pulmonology practices, and ProMBS describes support for independent pulmonologists. Ask each company to confirm its acceptance criteria, staffing arrangement, and minimum at your collection volume. Put your real collections into the tool above to see how much the minimum matters.
Can a billing company guarantee more revenue?
ADS advertises a 90-day guarantee. Treat any guarantee as a question. What gets measured? Against what starting point? What happens if they miss? Ask for the eligibility, measurement method, baseline, time period, and remedy in writing before relying on it.
Does MedicalBillingSelect send my information to these companies?
No. We don't request quotes for you or pass your details to anyone. You pick a company, go to its site, and decide what to share. How this site works.
I'm a patient with a bill from a lung doctor. Can you help?
This page is for practices choosing a billing company. For your bill, call the number on your statement. If the problem is what your plan covered, call your insurer next.
How we checked
We read each company's own public pages on October 5, 2026. We did not hire, test, or interview any of them. Everything in the comparison is what the company publishes about itself.
We picked companies that sell billing to pulmonology practices and publish enough to compare. Being listed is not a recommendation. Being left out is not a mark against anyone.
The billing rules come from Medicare's own policies and its regional contractors, linked next to each rule. They are Medicare rules. Your other payers may differ, and coding decisions belong to your qualified billing staff.
The quote examples are our arithmetic on made-up numbers.
Prices and terms change. If something here is out of date, tell us and send a link.