Radiology Billing That Captures Every Dollar You've Earned

Radiology billing is defined by the professional/technical split. The reading radiologist bills the professional component with modifier 26; the facility or imaging center bills the technical component with TC; only when one entity owns both does the global code apply. Billing global when the scan ran on hospital equipment — or omitting 26/TC entirely — is the single largest source of radiology denials and downcoding.

The Multiple Procedure Payment Reduction (MPPR) reduces the technical and some professional components when multiple imaging studies are performed in the same session — payers apply it automatically, sometimes over-aggressively, and groups that don't audit their remits lose legitimate dollars. Advanced imaging (CT, MRI, PET) almost always requires prior authorization through a radiology-benefit manager, and contrast administration and supply (Q-codes) must be captured separately.

REL1EF bills the correct 26/TC components, audits MPPR application on every multi-study session, and manages advanced-imaging prior authorization so reads don't deny for missing auth. For hospital-based and out-of-network radiology groups we benchmark professional-component claims against UCR and Fair Health data and negotiate underpayments — while eliminating the root-cause denials: component-split errors, MPPR over-reduction, and authorization gaps.