Radiology billing company for imaging centers and radiology groups
Radiology Medical Billing Services
BilNow handles radiology medical billing: professional and technical components, modifiers 26 and TC, prior authorization for MRI, CT and PET, and denials. Radiology billing services from 2.7% of collections, with no setup fee and no long-term contract.
Book a free demoSee pricingNo setup fee. No long-term contract. HIPAA-trained team. Founded 2017, headquartered in New York.
Radiology medical billing for imaging centers and radiology groups
BilNow is a radiology billing company for radiology groups, imaging centers, hospital-based radiologists and teleradiology practices. Radiology is billed differently from most specialties because one study often produces two claims, a technical claim and a professional claim, sometimes from different organizations. We set the component, check authorization and work every denial, from 2.7% of collections with no setup fee and no long-term contract.
- Radiology groups: professional claims for interpretation, billed with modifier 26 when a facility owns the equipment.
- Imaging centers: global and technical claims for MRI, CT, PET, ultrasound, X-ray and mammography.
- Hospital-based radiologists: professional billing aligned with the facility’s technical claim.
- Teleradiology practices: remote reads billed under each payer’s place of service and enrollment rules.
- Interventional radiology: procedure coding with attention to imaging guidance bundling.
Professional and technical component: modifiers 26, TC and global billing
Medicare’s Claims Processing Manual, chapter 13, treats the professional component (PC) and technical component (TC) of radiology as separate payable pieces. Section 20.1 says the PC is the physician’s interpretation and includes a written report. Section 20.2 covers the TC, and section 20.2.1 explains that a Part B contractor may not pay the TC for services furnished to hospital patients, because the hospital is paid for it. The modifier you choose must match who performed which part.
| Scenario | Who bills | Component on the claim | Billing note |
|---|---|---|---|
| Imaging center owns the equipment and its radiologist reads the study | One entity | Global, no 26 or TC | Billing global for only one part of the service, or adding 26 or TC to a code that cannot be split, is a common error. |
| Radiology group reads a study done at another facility | Radiology group | Professional, modifier 26 | Place of service follows where the patient had the technical service. |
| Facility performs the scan and an outside radiologist reads it | Facility | Technical, modifier TC | The reader bills the professional part separately. |
| Hospital outpatient exam read by a private radiologist | Hospital and radiologist, separately | Hospital technical claim, radiologist 26 | Medicare pays hospital outpatient imaging under the outpatient payment system, per chapter 13, section 20.2. |
| Test purchased from another supplier | Billing physician or supplier | Depends on the arrangement | Chapter 13, section 20.3, describes the anti-markup rule, which can cap payment when the performer does not share a practice with the biller. |
Radiology CPT code ranges and contrast billing
Radiology CPT codes sit mostly in the 70000 to 79999 range. The table is a working map. Always confirm descriptors and component rules in the current CPT and HCPCS books and your payer’s fee schedule.
| Range | Typical services | Billing focus |
|---|---|---|
| 70010-76499 | Diagnostic radiology, including X-ray, CT and MRI | Component split, contrast, laterality, authorization for CT and MRI |
| 76506-76999 | Diagnostic ultrasound | Complete versus limited exams, documented images |
| 77001-77022 | Radiologic guidance | Separate reporting only where the primary code allows it |
| 77046-77067 | Breast imaging | Screening versus diagnostic status and plan rules |
| 77261-77799 | Radiation oncology | Treatment planning and delivery rules; see our oncology billing services |
| 78012-79999 | Nuclear medicine, including PET | Radiopharmaceutical supply codes, units, PET indications |
Contrast media and radiopharmaceuticals are normally billed with separate HCPCS supply codes. Units must match the agent and volume in the record, and some payers want the drug name, strength and NDC. Mismatched supply lines are a frequent cause of partial denials.
Prior authorization for MRI, CT and PET
Many commercial and Medicare Advantage plans require approval before advanced imaging, often through a radiology benefit manager. The scanning facility is commonly expected to confirm the approval, and a scan without it is typically denied even when medically necessary. Emergency and inpatient imaging is generally handled differently, but the rules vary by payer. We check authorization status at scheduling and again before billing, and our prior authorization services team can submit requests for you.
Medicare AUC program status
CMS’s Appropriate Use Criteria program for advanced diagnostic imaging is paused. The CMS program page states that CMS has paused efforts to implement it for reevaluation, rescinded the regulations at 42 CFR 414.94 in the CY 2024 Physician Fee Schedule final rule, and set no timeframe for resuming. Since January 1, 2024, providers and suppliers should not include AUC consultation information on Medicare fee-for-service claims. The page we read was last modified in March 2026. See the CMS AUC program page. Prior authorization rules from commercial plans and Medicare Advantage are separate and still apply.
Multiple procedure payment reductions for imaging
CMS Transmittal 3578 (Change Request 9647) explains the Medicare multiple procedure payment reduction for certain diagnostic imaging. When the same physician, or a physician in the same group practice, furnishes more than one procedure to the same patient in the same session on the same day, the professional component of each additional procedure is paid at 95 percent of the fee schedule amount from January 1, 2017. The transmittal states the technical component reduction remains at 50 percent. We compare remittances against these expected amounts, and commercial plans often use their own reduction logic that we map for each contract. Source: CMS Transmittal 3578.
Diagnosis coding, teleradiology and place of service
Diagnoses should support the exam and come from the final interpretation, not only from the order. Teleradiology adds a place of service question. Chapter 13, section 150, says the POS code on the professional component is generally the setting where the beneficiary received the technical component. Its example is an MRI at an outpatient hospital, read from the physician’s office, reported with POS 22. Remote readers also need state licensure and payer enrollment, which our medical credentialing services team tracks. Source: Medicare Claims Processing Manual, chapter 13.
How our radiology billing services work
1. Eligibility and authorization
We verify benefits and confirm authorization for MRI, CT and PET before the scan, and record the approval number against the order.
2. Charge entry with the right component
We set global, 26 or TC from equipment ownership, who read the study and where the patient was scanned.
3. Coding and diagnosis review
Our team checks that the diagnosis from the final report supports the CPT code, contrast units match the record, and payment-affecting modifiers are present.
4. Claim submission and posting
Claims pass payer-specific edits before submission, and payments are posted against expected multiple-procedure amounts.
5. Denial management
Denials are classified, appealed and tracked to payment. Our denial rate runs under 5% and our first-pass claim rate is 98%. See denial management.
6. Reporting
You see collections by modality, reader, payer and facility, plus top denial reasons.
BilNow was founded in 2017, is headquartered in New York and supports more than 300 providers. Our team is HIPAA-trained and clients rate us 4.4 on Trustpilot. Rates are on the pricing page, and our outsource medical billing services page explains what changes when you hand billing over.
Common radiology denials and how we prevent them
| Denial pattern | Typical cause | How we fix and prevent it |
|---|---|---|
| No authorization or mismatched authorization | Approval missing, expired, or for a different CPT or facility | Verify at scheduling and before billing; request retro-authorization where the plan allows |
| Medical necessity | Diagnosis does not support the exam | Code from the final report; query the ordering provider when the order is vague |
| Component and modifier errors | Global billed for a split service, or 26 or TC applied to the wrong party | Set the component at charge entry from ownership and reader |
| Contrast and supply mismatches | Units or agent differ from the record | Reconcile supply lines to the technologist’s documentation |
| Duplicate or bundled codes | Repeat submission or a code included in another | Run bundling edits before submission; correct rather than resubmit blindly |
| Eligibility or provider data | Coverage change, wrong NPI or enrollment gap | Verify eligibility on the date of service and track enrollment |
Use our denial code lookup to decode the reason codes on a remittance, and check each payer’s deadline on our timely filing limits page before you appeal.
Payer and state notes for radiology billing
Medicare follows the manuals cited above, while Medicare Advantage and commercial plans set their own authorization, reduction and enrollment rules, and Medicaid varies by state. We keep a payer sheet for your account and do not assume one plan’s rule applies to another. We bill for imaging providers in states including New York, Texas, Florida and California.
Radiology billing FAQ
What is radiology medical billing?
Radiology medical billing is the process of turning imaging exams into paid claims. One exam can create a technical charge for the equipment, technologist and facility, and a professional charge for the radiologist’s interpretation. Billing has to split, modify and route those charges correctly, confirm authorization for advanced imaging, and follow up every denial.
What do radiology billing services include?
BilNow radiology billing services cover eligibility checks, prior authorization status, charge entry with the correct component modifier, coding review, claim submission, payment posting, denial appeals and reporting. We work inside your RIS, PACS-linked billing system or EHR.
What is the difference between modifier 26 and modifier TC?
Modifier 26 marks the professional component, the radiologist’s interpretation and written report. Modifier TC marks the technical component, the equipment, supplies, technologist and facility. When one provider furnishes both parts, the global code is billed without either modifier. Medicare’s Claims Processing Manual, chapter 13, describes the professional and technical components of radiology services separately.
Do MRI, CT and PET scans need prior authorization?
Often, yes, for commercial and Medicare Advantage plans, which commonly route advanced imaging through a radiology benefit manager. Rules differ by plan, order type and place of service, so we check authorization status at scheduling and again before the claim goes out.
Is the Medicare AUC program still in effect?
No. CMS says it has paused the Appropriate Use Criteria program for reevaluation and rescinded the regulations at 42 CFR 414.94, effective January 1, 2024. Providers and suppliers should no longer include AUC consultation information on Medicare fee-for-service claims. CMS has not set a timeframe for resuming it.
How do multiple procedure reductions affect imaging payment?
Under CMS Transmittal 3578, when the same physician or group furnishes multiple imaging procedures to the same patient in the same session on the same day, Medicare pays 95 percent of the fee schedule amount for the professional component of each additional procedure. The technical component reduction remains at 50 percent. Commercial plans set their own rules.
What place of service goes on a teleradiology claim?
For Medicare, chapter 13 of the Claims Processing Manual says the place of service on the professional component is generally the setting where the patient received the technical component, even when the radiologist reads from a distant site. Its example is an MRI done at an outpatient hospital and read from an office, which is reported with POS 22.
What does a radiology billing company charge, and what does BilNow charge?
Fees vary by company and contract structure. BilNow charges from 2.7% of collections, with no setup fee and no long-term contract. Book a demo and we will review your modality mix, payer mix and denial history.
Can you work inside our EHR or RIS?
Yes. BilNow bills inside more than 100 EHRs, so your team keeps its current systems while ours handles charge review, claims, payment posting and denials.
Get radiology medical billing that splits every exam correctly
Book a demo and we will review your component modifiers, authorization process and denial history. No setup fee, no long-term contract.
Book a free demoRelated BilNow resources
- Prior authorization services
- Denial code lookup
- Oncology billing services
- Medical billing services in New York
- Medical billing services in Texas
- Outsource medical billing services
- Denial management services
- Medical coding services
- Medical credentialing services
- Pricing
- Timely filing limits by payer
- CPT modifiers cheat sheet
Updated October 2026. Code descriptions follow AMA CPT and CMS HCPCS Level II. Payer rules change, so confirm current policy before billing.