Neurology Billing Services in Louisiana

Louisiana's neurology practices face unique billing challenges shaped by Blue Cross Blue Shield of Louisiana's commercial rules, Healthy Louisiana requirements, and Novitas Solutions (Jurisdiction H) Medicare policies. Our AAPC-certified coders specialize in both LA payer rules and neurology coding complexity.

AAPC Certified
LA Payer Expert
Neurology Specialists
2.49% Rate
Last reviewed: May 2026Reviewed by the Go Medical Billing Editorial TeamAAPC-certified coders
13,000+LA Physicians
2.49%Starting Rate
5Medicaid MCOs
98%+Clean Claim Rate

Why Louisiana Neurology Practices Need Specialized Billing

Louisiana's healthcare market includes 13,000+ physicians, and neurology practices here face a payer market dominated by Blue Cross Blue Shield of Louisiana on the commercial side and Healthy Louisiana on the public payer side. Medicare claims are processed through Novitas Solutions (Jurisdiction H), which applies its own Local Coverage Determinations that directly affect neurology procedure coverage and medical necessity requirements. Generic billing teams without LA specific knowledge leave revenue on the table.

Neurology billing itself is complex. Neurology diagnostic testing codes have professional and technical components, time-based elements, and study-specific documentation requirements. EMG/NCS (95907-95913, 95885-95886) requires documenting specific nerves tested. EEG (95816-95822) has awake, sleep, and long-term monitoring variants. When you combine this coding complexity with Louisiana's specific payer rules, authorization requirements, and 5 Healthy Louisiana managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving neurology practices from New Orleans to Metairie and across Louisiana.

2026 Louisiana Medicare Allowables for Neurology CPT Codes

These are the 2026 Medicare allowable amounts for neurology CPT codes in Louisiana, processed under Novitas Solutions (Jurisdiction H). Allowables are locality-adjusted, so LArates differ from other states — the highest-value neurology code below pays $623.34 non-facility here. Compare any code across states with our Medicare fee calculator by state.

Code
Description
Non-Facility
Facility
Needle EMG, one extremity
$112.13
$112.13
Needle EMG, limited study
$80.16
$80.16
Electroencephalogram (EEG), 20-40 minutes
$381.03
$381.03
Polysomnography with 4 or more parameters
$623.34
$623.34
Established patient office visit, low MDM
$91.09
$56.64
Established patient office visit, moderate MDM
$130.02
$83.35
Established patient office visit, high MDM
$184.72
$123.73

Source: 2026 Medicare Physician Fee Schedule, LA locality (Novitas Solutions (Jurisdiction H)). Commercial Blue Cross Blue Shield of Louisiana rates typically run above these benchmarks; Healthy Louisiana rates run below. Figures for reference, not a guarantee of payment.

The Louisiana Market Context for Neurology Practices

Louisiana has about 13,000 physicians and a Healthy Louisiana managed care program that is in active transition. UnitedHealthcare exited the program effective April 1, 2026, leaving five MCOs: Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue (operated by BCBS Louisiana), Humana Healthy Horizons, and Louisiana Healthcare Connections (a Centene subsidiary). The UnitedHealthcare exit moved Medicaid members to the remaining plans, which means many Louisiana practices had to update their MCO mix and recredential members. Louisiana expanded Medicaid in 2016 under then-Governor Edwards, which added several hundred thousand newly eligible adults to the rolls. The commercial market is dominated by Blue Cross Blue Shield of Louisiana, which also operates Healthy Blue on the Medicaid side. Ochsner Health is the largest health system in the state, anchored in New Orleans and operating across Louisiana, Mississippi, and Alabama. Baton Rouge is anchored by Our Lady of the Lake (Franciscan Missionaries of Our Lady), Baton Rouge General, and the medical school presence of LSU Health Sciences. New Orleans is also home to LCMC Health, Tulane Health System, and Children's Hospital New Orleans.

Louisiana-specific factors that shape neurology reimbursement: UnitedHealthcare exited Healthy Louisiana effective April 1, 2026. The Medicaid managed care market is now down to five MCOs from the previous six.; Louisiana expanded Medicaid in 2016 under Governor John Bel Edwards. The expansion added several hundred thousand newly eligible adults and made Louisiana one of the first Southern states to adopt expansion.; Ochsner Health is the largest health system headquartered in Louisiana and operates one of the largest cardiac programs in the South, including a major heart transplant program.. Our LA coders build these into every neurologyclaim — see how this works alongside our Louisiana medical billing and neurology billing teams.

Louisiana Payer Challenges for Neurology

Every LA payer has specific rules for neurology claims. Here's how we navigate them.

Blue Cross Blue Shield of Louisiana Neurology Claims

Blue Cross Blue Shield of Louisiana processes the largest share of Louisiana commercial neurology claims. We know their LA specific fee schedules, prior authorization requirements for neurology procedures, and their appeal timelines when claims are denied. Nerve conduction and needle EMG have separate code families that must be coordinated.

Healthy Louisiana Neurology Billing

Healthy Louisiana routes neurology patients through 5 managed care plans: Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue (BCBS Louisiana), and 2 more. Each MCO has its own neurology authorization and billing rules that we manage.

Medicare (Novitas Solutions (Jurisdiction H)) Neurology Coverage

Novitas Solutions (Jurisdiction H) processes Medicare neurology claims in Louisiana with its own Local Coverage Determinations. We navigate Novitas Solutions (Jurisdiction H)'s policies around eeg variant selection to prevent medical necessity denials.

Denial Prevention for Louisiana Neurology

Common neurology denials in Louisiana include nerve conduction and needle emg have separate code families that must be coordinated and routine, extended, ambulatory, and video eeg each have different codes and documentation. Our team catches these issues before submission and appeals aggressively with LA payer-specific documentation when denials occur.

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What We Handle for Louisiana Neurology Practices

EEG coding (routine, extended, video, ambulatory)
EMG and nerve conduction study billing
Sleep study billing (PSG and HST)
Neurology infusion therapy coding
Botox injection billing (migraine, spasticity)
Prior auth for advanced neuro testing

Louisiana Neurology Billing Cost Comparison

Hiring an in-house biller with neurology expertise in Louisiana costs $30K-$42K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified neurology coders and LA payer specialists for a fraction of that cost.

$30K-$42K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

Frequently Asked Questions

All major LA payers: Blue Cross Blue Shield of Louisiana, Aetna, UnitedHealthcare (exiting April 2026), Humana, Cigna, Healthy Louisiana (including Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue (BCBS Louisiana)), and Medicare through Novitas Solutions (Jurisdiction H). If a payer accepts neurology patients in Louisiana, we submit and follow-up on claims with them.
The most frequent neurology denials we see from LA payers include nerve conduction and needle emg have separate code families that must be coordinated, routine, extended, ambulatory, and video eeg each have different codes and documentation, neurology infusions (biologics, ivig) require sequential administration coding. Our team catches these before submission by applying both neurology coding expertise and LA payer-specific rules to every claim.
Healthy Louisiana routes neurology patients through 5 managed care plans: Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue (BCBS Louisiana), Humana Healthy Horizons in Louisiana, Louisiana Healthcare Connections (Centene). Each MCO has its own neurology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your neurology practice gets paid correctly.
Most LA neurology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your neurology workflows, and start submitting claims to Blue Cross Blue Shield of Louisiana, Healthy Louisiana, Medicare, and all your LA payers with no downtime.

Fix Your Louisiana Neurology Billing

Call 888-701-6090 for a free billing assessment specific to your LA neurology practice. We'll show you where revenue is leaking and how to fix it.