While fee schedules must legally be “usual and customary,” no set rules exist for how physicians must set up fee schedules, and much of them are service dependent, according to AAPC.
Providers who own equipment and process their own diagnostic studies can charge global fees for service, while groups who only interpret studies can use the appropriate CPT code with a 26 professional services modifier for the professional component, according to the release.
For groups with equipment but no one to interpret the studies, they may bill for the technical portion with the CPT code and the TC technical component modifier. Groups may also bill based on the facility in which services are provided.
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Providers who own equipment and process their own diagnostic studies can charge global fees for service, while groups who only interpret studies can use the appropriate CPT code with a 26 professional services modifier for the professional component, according to the release.
For groups with equipment but no one to interpret the studies, they may bill for the technical portion with the CPT code and the TC technical component modifier. Groups may also bill based on the facility in which services are provided.
More Articles on Coding, Billing and Collections:
5 Questions to Assess ICD-10 Vendor Readiness
Maine Hospitals Support Legislation to Determine Patient Pay Ability
Ingenious Med's Software Now Supports Outpatient Billing