Billing Radiology Services Professional and Technical Components - JE Part A

Generally, imaging services are split into technical and professional components (TC and PC), each separately billable to the local Medicare contractor. Medicare pays under the Medicare Physician Fee Schedule (MPFS) for TC of imaging services furnished to Medicare beneficiaries who are not patients of any hospital, and who receive services in a physician's office, a freestanding imaging or radiation oncology center, ambulatory surgical center (ASC), or other setting that is not part of a hospital.

• PC is for physician work interpreting a diagnostic test or performing a procedure and includes indirect practice and malpractice expenses related to that work. Modifier 26 is used with the billing code to indicate that the PC is being billed.
• TC is for all non-physician work, and includes administrative, personnel and capital (equipment and facility) costs, and related malpractice expenses. Modifier TC is used with the billing code to indicate that the TC is being billed.

PC and TC do not apply to physician services that cannot be distinctly split into professional and technical components. Modifiers PC and TC may not be used with these billing codes.

• Check the annual MPFS Indicator List and Descriptors that provide the P/T breakdown of all codes.