Pediatric Critical Care EHR and AI Medical Billing Software

Pediatric intensivists bill time and complexity in the hospital. XEHR makes sure the documented time and care reach the claim.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Respiratory distress on high-flow oxygen.

J96.01 Acute respiratory failure with hypoxia

ReviewSign note

Diagnosis carried to the claimJ96.01

THE HARD PARTS

What makes pediatric critical care billing hard

Critical care billed by time

Payment depends on documented time, excluding separately billed procedures.

Procedures during critical care

Procedures on the same day need clear separation from critical care time.

Handoffs between intensivists

Several providers may bill the same patient on the same day.

WHERE THE WORK HAPPENS

How pediatric critical care care is delivered and billed

Pediatric intensivists work in pediatric intensive care units and on transport teams. Care is billed on the professional claim with the hospital place of service, mostly as daily pediatric critical care whose level depends on the child’s age, plus procedures such as intubation and central lines. Families are present and involved, and consent comes from parents or guardians.

What payers check on pediatric critical care claims

Pediatric critical care is billed as a daily service whose level depends on the child’s age.
Some procedures are included in daily pediatric critical care and cannot be billed separately.
When the child is no longer critical, care is billed as a hospital visit instead.
Diabetic ketoacidosis is coded with the diabetes type and whether coma is present.
Consent for procedures on a minor comes from a parent or legal guardian.

Common pediatric critical care diagnoses ICD-10-CM

J96.01	Acute respiratory failure with hypoxia
J21.9	Acute bronchiolitis, unspecified
E10.10	Type 1 diabetes mellitus with ketoacidosis without coma
J45.52	Severe persistent asthma with status asthmaticus
R56.9	Unspecified convulsions
A41.9	Sepsis, unspecified organism

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A pediatric critical care visit, start to payment

1
Admit and stabilize

Admission findings, procedures and the plan are documented with the parent or guardian recorded.
2
Daily critical care

Each day’s note records the child’s condition and support, which decides the daily service billed.
3
Procedures documented

Bedside procedures are recorded with indication and technique.
4
Bill and step down

Daily services and procedures go out with the hospital place of service; transfer to the ward changes the service type.

How XEHR helps

From the pediatric critical care visit to the payment

Time captured in the noteCritical care time is documented for billing.
Procedures documented separatelyProcedures are recorded apart from time-based care.
Each provider bills their own workClaims follow the provider who documented the care.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for pediatric critical care

AI medical billing for pediatric critical care practices

XEHR is an agentic EHR: AI agents do the administrative work around every pediatric critical care visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Pediatric critical care is billed as a daily service whose level depends on the child’s age.
Some procedures are included in daily pediatric critical care and cannot be billed separately.
When the child is no longer critical, care is billed as a hospital visit instead.
Diabetic ketoacidosis is coded with the diabetes type and whether coma is present.

Around the visit

Agents run on their own

Coverage checked before each pediatric critical care visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a pediatric critical care EHR

Ask every vendor, including us. The answers show whether a system was built for pediatric critical care work or only adapted to it.

Ask us on a demo

Is daily pediatric critical care billed at the level the child’s age supports?
Are bundled procedures kept off the claim?
Does the record switch to hospital visits when the child is no longer critical?
Is consent recorded with the parent or guardian?
Can transport care be documented in the child’s record?

QUESTIONS

Pediatric Critical Care practices ask us

Does XEHR support time-based critical care billing?

Yes. Documented time carries onto the claim.

Can XEHR bill procedures done during critical care?

Yes, when they are documented separately in the note.

Does XEHR handle pediatric ICU billing?

Yes. Daily critical care is documented and billed at the level the child’s age and condition support.

Can XEHR record transport team care?

Yes. Transport care is documented in the child’s record from the first contact.

Does XEHR support cardiac ICUs for children?

Yes. Post-operative and medical cardiac care is documented and billed.

Can XEHR record family meetings in the PICU?

Yes. Meetings, decisions and time are recorded.

How much does XEHR cost for a pediatric critical care practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a pediatric critical care practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

See all specialties

See XEHR set up for pediatric critical care

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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