Medical Billing Forum

Billing => Billing => : NYMBS October 20, 2009, 04:25:41 PM

: Modifier 26 - HELP!
: NYMBS October 20, 2009, 04:25:41 PM
I have a provider in TX who perform outpatient E/M services on hospital own property.  The hospital is billing for the technical component  and collecting a copayment ???.  They want me to bill for the professional component.  I didn't think you can split E/M billing.  Can you bill an E/M CPT (99205 - 99215) with modifier 26?
: Re: Modifier 26 - HELP!
: Priyan October 21, 2009, 07:23:51 AM
Yes, Your are exactly correct, nothing to get confused in this.

For any E&M we cannot apply MOD 26 as E&M codes itself is professional service and not a technical one.

We bill these codes only for the evaluation of PT by our physician

In every card we will have seperate details on copay for E&M for physician and Sepcialist

Priyan.D