1073358
Expert
Can MRI be billed as incident to?
Modifier -26; Professional Component, usually billed by the radiologist who interprets the imaging.
Modifier -TC; Technical Component, billed by the facility for use of their equipment. If the radiologist works for the facility, then the whole component is billed.
Just ordering the MRI is not a separate billable event as it is included in the E&M code.
I have seen this same question asked several time recently in the forum.
The PA cannot report the TC portion of the MRI, this is beyond their scope and so only the supervising physician can report the TC component. It has to do with the type of supervision they (radiology procedures) need. Per the Centers for Medicare & Medicaid Services (CMS) Internet Only Manual (IOM) Publication 100-02, Medical Policy Benefit Manual, Chapter 15, Section 80.
PER CMS:
This is effective for those claims that are billed as non-incident to the physicians service. When the PA or NP is listed as the servicing or rendering provider, it has been determined that billing the technical component of an x-ray is not within the PA/NP scope of practice.
If the PA/NP billing is submitted to Medicare as a non-incident to service, the PA/NP NPI can be reflected as the servicing or rendering provider for the professional component of the x-ray using the AMA-CPT code for the x-ray and Modifier 26. The technical (TC) component must be submitted showing the NPI of the supervising MD/DO on another line of the claim.
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