Nursing homes, rehabilitation centers, and long-term care facilities are facing an exceptionally difficult financial environment for collecting payments from the Medicare and Medicaid programs. The Patient Driven Payment Model (PDPM), recently implemented by CMS, has changed how skilled nursing facilities (SNFs) obtain revenues through all five payment categories.
Medicare Part A and Part B billing requirements grow more complex each year, and Medicaid reimbursement rates vary enough between states to make multi-facility billing a genuine compliance risk without the right partner
When you select the wrong billing company for your facility, you are not only stopping collections from occurring quickly; you are actually taking away from your facility’s EBITDA each quarter. This ranking evaluates the top 10 nursing home billing companies in the USA for 2026 based on verified clean claim performance, PDPM expertise, nationwide service reach, independently confirmed trust ratings, and documented client outcomes.
Top 10 Nursing Home Billing Companies
1. Nexus IO
Started in 2015 and based in Phoenix, Arizona, Nexus io offers AI-driven revenue cycle management across 50+ specialties and every state in the USA – making them the most versatile and capable nursing home billing partner on this list! Their unique platform is designed for high-volume skilled nursing facilities and post-acute care environments, where the accuracy of the PDPM components and the precision of the consolidated billing will directly result in your per diem reimbursement outcome.
All of the revenue cycle stages will be managed by AAPC-certified coders, from verifying Medicare Part A and B eligibility through denial resolution and full accounts receivable recovery with real-time dashboards that provide total visibility of your claims to the business office manager without having to wait for a monthly report.
On Trustpilot, Nexus io has a verified rating of 4.8 stars out of 5 from clients across all types of facilities, demonstrating consistent satisfaction from their clients. 98% of first pass clean claims, 97% collection ratio, and an average 30% decrease in the number of AR days make Nexus io the go-to provider for skilled nursing facilities that want to stop leaving reimbursable revenue on the table.
2. Billing Freedom
Billing Freedom is located in Frisco, Texas, and became an accredited BBB member in August 2025. As a company that has been in business since 1996, BillingFreedom has proven itself by maintaining a clean claim submission rate of 96% and has a high retention rate of 99%. This is verified through numerous published testimonials from their customers as well as verified reviews on Trustpilot.
BillingFreedom has a team of AAPC/ACCP certified billers and coders who specialize in the accurate management of Medicare and Medicaid skilled nursing facility (SNF), especially with the accurate documentation of long-term care, proactive resolution of insurance denial appeals, and multi-level review of claims prior to submission.
BillingFreedom integrates easily with all major electronic medical record (EMR) systems, so there are no data entry responsibilities for facility staff. Their TrustPilot reviews indicate that the two-year customer relationship is built on attentive service, accurate billing, and proactively resolving disputes with insurance companies (that in-house staff cannot resolve). They also have a specialty in reducing the accounts receivable days for independent SNFs that require a cost-effective billing partner with high accuracy, but do not want the costs associated with enterprise-level pricing.
3. Human Medical Billing
In Ventura, California, Human Medical Billing was founded in 2001 and has been providing nursing homes and skilled nursing facilities with over 20 years of revenue cycle experience. They have a BBB A+ rating and accreditation as of February 2024, so you can rest assured you’ll receive quality service from an established organization.
They work with over 25 electronic health record (EHR) systems and specialize in recovering aged AR, which is why they have been so valuable to skilled nursing facilities that have had a large number of unpaid claims due to poor billing practices by past billing providers, who never pursued denied claims or underpaid claims.
They list client testimonials on their website stating clients have increased their monthly collections by 20% within 3 months of using their services. Their specialty in skilled nursing facilities is denial reversals, aged AR recovery, and revenue stabilization for private nursing facilities and rehabilitation centers that want results immediately.
4. Omega Healthcare
Omega Healthcare, which was established in 2003 and has its corporate location in Boca Raton, Florida, is a leader in the field of revenue cycle management (RCM) and has 30,000 employees in 14 delivery centers globally (the United States, India, Colombia, and the Philippines), making it a technology-driven healthcare company. In February 2026, Omega Healthcare received a 97.8 out of 100 for its overall performance score and won the Best in KLAS award for Ambulatory Revenue Cycle Services with A+ ratings from KLAS clients for both Value and Loyalty.
One of the verified KLAS client reported high satisfaction with Omega Healthcare’s services and is currently expanding Omega’s services throughout their organization. Omega Healthcare’s artificial intelligence (AI) platform provides a complete end-to-end revenue cycle solution, including prior authorizations, charge capture, clinical documentation improvement, claim denial management, collection, etc., that can be operated at scale without disrupting current workflows.
Nursing home chains in need of enterprise-grade RCM technology that incorporates clinical human oversight should consider Omega Healthcare the ultimate gold standard.
5. GeBBS Healthcare Solutions
GeBBS Healthcare Solutions, a Los Angeles-based provider KLAS Rated, is in the Top 10 RCM Firms by Modern Healthcare, and one of the Top 20 RCM Outsourcing Services by Black Book Market Research with over 9,500 professionals.
Chrys Capital is a Private Equity firm that provides support to GeBBS Healthcare Solutions. The company combines health information management with revenue cycle outsourcing, making it one of the few nursing home billing providers capable of handling MDS documentation support, ICD-10 coding accuracy, eligibility verification, and extended office functions under a single engagement.
Their SNF billing specialty targets mid-market operators and multi-site facilities that require Medicaid-pending expertise, complex payer management, and coding accuracy that holds up under CMS audit review.
6. R1 RCM
R1 RCM, one of the largest providers of revenue cycle management services in the United States, provides hospitals, medical practices, or post-acute providers affiliated with healthcare systems with a full range of functions via an end-to-end technology platform that includes robotic process automation (RPA), machine learning (ML), and AI based on analytics to reduce accounts receivable days, identify under payments, and prevent denials prior to claims leaving the facility.
The platform offers such tools as chargemaster optimization, contract management, and charge capture tools that identify revenue leakage at coding rather than after adjudication. Several KLAS-rated R1 RCMs’ service lines, while their predictive denial technology is particularly well-respected among clients in healthcare systems managing large volumes of skilled nursing facility claims from a wide range of payers.
R1 RCM also has ancillary services for skilled nursing facilities that are typically only available through larger health care systems and need the technology infrastructure.
7. SNF Solutions
SNF Solutions is a North Bend, WA-based nursing home billing company specializing only in skilled nursing facilities. In contrast to all the other medical billing firms out there (and all the other billing types), that are unable to focus specifically on SNF-related billing, our clients usually see an average 48% recovery of their outstanding AR within the first 90 days after we engage them. One of our clients experienced this kind of success and subsequently handed over to us all of their business office billing function.
Additionally, our billing solution has garnered another verified testimonial, which states that we have provided exceptional results for the facility for over seven years at significantly less expense than the previous billing service provider. Our comprehensive Billing, Consulting, Collections, Business Office Training, and Temporary Staffing solutions offer complete coverage of the operational requirements of SNF administrations when their business office is underperforming.
Specifically, our ability to provide comprehensive business office recovery and long-term partnerships with SNFs will support their need for expertise (beyond just submission of claims).
8. MedxCode
MedxCode has a competitive fee structure for their services (3.99% of monthly collections based upon their website), which makes them one of the few SNF billing companies in the industry with publicly stated pricing rather than requiring a phone call to learn about eligibility. Real-time claim monitoring/eligibility verification/data capture features are built into MedxCode’s system, which provides a true real-time view of claims throughout the entire billing cycle, while also streamlining SNF workflow through integration of these elements as opposed to using a general medical billing format.
The specific billing services provided by MedxCode are designed to be compatible with the PDPM (Patient-Driven Payment Model). They have extensive experience in each of the five PDPM payment components, including all aspects of the consolidated billing process, MDS documentation support, as well as assisting facilities in achieving accurate Part A and Part B Medicare billing to avoid case mix miscalculations that have a detrimental impact on per diem reimbursements for each resident’s stay.
MedxCode specializes in optimizing and ensuring compliance within the SNF billing components of the PDPM for facilities where there have been lost revenues due to missing documentation in the billing process.
9. Sunknowledge
Sunknowledge has been delivering dedicated Long-Term Care & Skilled Nursing Facility (SNF) billing services to SNFs throughout the United States for the past 10 years, establishing a solid history of being an operational support unit for SNF operators that need consolidated Medicare Part A (A)/B (B) Billing, without incurring the additional overhead associated with hiring additional business office personnel.
For $7 per hour (flat-rate pricing, everything included), Sunknowledge offers one of the most transparent pricing methods in the SNF billing industry, allowing budget-conscious facilities to manage their costs effectively. In addition to providing cost-effective invoice management services, Sunknowledge’s service model delivers prior authorization, AR follow-up, denial management, and IVR (interactive voice response) based insurance follow-up processes to eliminate delays caused by manual intervention while maintaining claim flow.
Customer references confirm that Sunknowledge consistently integrates into customer operations without requiring changes to the facilities’ current processes and has successfully continued this trend since its inception as an SNF billing company. Their SNF billing specialty is providing cost-effective invoice management to facilities that require support from experienced LTC professionals at a controllable expense.
10. 24/7 Medical Billing Services
With a 99% accurate self-reported score for its billing system across all states and a proven track record of working with multiple state agencies, 24/7 Medical Billing Services features an established division focused on providing services specific to skilled nursing facilities billing, offering high-quality strategies to verify benefits for the 10% to 15% of skilled nursing facility claims that are rejected at the payer level for reasons unrelated to coding issues.
The area of specialty for 24/7 Medical Billing Services in their SNF Division is verifying benefits, accuracy, and preparation procedures for filing SNF claims and submitting to the appropriate payers so that experienced and inexperienced providers have access to SNF billing as accurate as required within the appropriate timeframe.
How to Choose the Right Nursing Home Billing Partner
There are three criteria that should be utilized when making SNF billing decisions this year.
Match scale to facility size
Large enterprise providers such as R1 RCM or Omega Healthcare have sophisticated billing capabilities from a payer perspective, as well as technology requirements designed to support large chains. Independent and regionally based SNFs will benefit from more timely responses and more direct account management through specialized providers such as SNF Solutions, MedxCode, and Nexus io.
Prioritize PDPM documentation accuracy above all else
Under the new Patient-Driven Payment Model (PDPM), miscalculation of any of the five payment components can silently compound throughout the entire SNF stay (contact SNF billing partners and specifically ask about how they are auditing PDPM case-mix capture and not just the accuracy of their general claim).
Verify trust signals independently
BBB accreditation, KLAS rating, and testimonials are a baseline, but these should be enhanced with requesting references from similar payer mixes and similar resident census as compared to yours before entering into any contractual relationships (the top billing providers will welcome the discussion).
Conclusion
Getting nursing home billing right in 2026 requires more than timely claim submission. It requires verified PDPM expertise, proven Medicare Part A and Part B accuracy, and the infrastructure to convert denied claims into collected revenue before they age past recovery.
The companies listed here have all earned their place on this list by providing documented results/industry recognition received through independent verification of their expertise. This means that regardless of whether your facility is looking for enterprise-level AI technology, SNF-only business office assistance, or a long-term care billing model that is transparent in its pricing, there will be a company from this list that meets your needs.
For SNFs evaluating whether to outsource nursing home billing, Nexus IO is worth a direct look. Their platform integrates with PointClickCare and MatrixCare, provides real-time PDPM and MDS 3.0 guidance, and applies AI-powered claim scrubbing before payer submission. A 98% clean claim rate, 97% collection ratio, and no long-term contracts keep the relationship accountable to results.
