Revenue Cycle: Professional Services

(33 customer reviews)



Since coding is such an important part of the reimbursement cycle, it makes sense that you know the basics of the revenue cycle as it relates to billing for professional services. This course will explore billing for professional services, different types of payers, RVU concept, importance of medical necessity and an introduction to LCDs and NCDs.



Lesson 1: Introduction to Professional Fee Coding and Revenue Cycle

  • Differentiate between professional fee coding and facility coding
  • Identify the claim form that is generally used for billing profession fee services
  • Define common medical billing terms

Lesson 2: Insurance Basics

  • Define common terms used when talking about health insurance
  • Compare different types of healthcare insurance plans
  • Differentiate between Medicare and Medicaid

Lesson 3: Payer Mix and the RBRVS

  • Describe the Resource-based Relative Value Scale and examine how it applies to payment
  • Select information available on the Medicare Physician Fee Schedule

Lesson 4: Medical Necessity and Coverage Determinations

  • Discover what a Medicare Administrative Contractor (MAC) is and which regions they cover
  • Differentiate between a local and national coverage determination

Target Audience

  • Professional Fee Coders 
  • Billing Professionals 

CE Credits

This program has been approved for 1 continuing education units for use in fulfilling the continued education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.

This program has the prior approval of the American Academy for Professional Coders (AAPC) for 1 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Purchasing Details

  • Upon purchase, you will have a 6-month subscription to this course. This will allow you the opportunity to complete and review as often as you like for 6 months.
  • Courses are accessed through
  • Visit our FAQ page for technical requirements and additional details.

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