In what circumstances is modifier 26 (professional component) reported?

Certain procedures (eg, electrocardiograms, radiographs, surgical diagnostic tests, laboratory tests) include a professional and technical component. The professional component includes the physician work (eg, interpretation of the test, written report). The technical component includes the costs associated with providing the service (eg, equipment, salaries of technical personnel, supplies, facility expense). If a physician is performing the service with equipment owned by a facility or another entity, the services are reported with modifier 26.Current Procedural Terminology (CPT®) does not include a modifier for reporting the technical component. However, most payers recognize Healthcare Common Procedure Coding System modifier TC (technical component) and the facility would therefore report the same service using modifier TC. When the physician owns the equipment and is performing the technical and professional services, a modifier should not be appended to the code.

Tip:To see if the professional...

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