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The Technical and Professional Components of Radiological Services

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The Technical and Professional Components in Radiological Services
Tabitha Schumacher

Differences

Technical Component is the billing for the equipment supplies technicians and faculty only, not for the interpretation service. Also uses the modifier TC when coding a service. The Professional Component which uses the modifier 26 is used when a physician is billing for the interpreting and reporting of the results, but not the actual testing. (Dolby, 2007)
Technical Components in Medicare
Technical components are given to patients in a hospital or Skilled Nursing facility with Part A coverage can’t be covered by insurance carriers. Instead the fiscal intermediary makes the payment for the administrative/supervisory services offered by the physician. The technical component services for patients in a hospital with Medicare are included in the fiscal intermediary’s part A and B payments to hospitals. Outpatients are billed according to the hospitals Outpatient Prospective Payment System (OPPS) to the hospital. Patients in a Skilled Nurses facility are billed according to the Skilled Nursing facility’s Prospective Payment System (PPS). (Clement, 2011)
Professional Component Billing Physicians are allowed to bill for the professional Component regardless of their specialty. Reimbursement for the Professional Component is given of a fee schedule for a physician’s service. Radiological services given at a hospital are only reimbursed if the following criteria are met. The first one is that the services meet the fee schedule conditions. The second one is the services provided were identifiable, direct and diagnostic or therapeutic. (Clement, 2011)

Bibliography
Clement, J. (2001, April 4th). Radiology Medical Biling. Retrieved from Managed Outlook Services: http://www.outsourcestrategies.com/blog/2011/04/radiology-medical-billing.html
Dolby, R. (2007,…...

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