Confirms coverage and identifies which radiology benefit manager, if any, controls authorization for the ordered study before it is scheduled.
Radiology Medical Billing Services
Radiology Medical Billing Services Built for CT, MRI, and Interventional Imaging Claims
From X-ray and CT to MRI, mammography, and interventional radiology, we bill every modality and component split a radiology practice depends on.
Certified Billing & Coding Support
HIPAA-Conscious Workflows
Imaging Claims & Denials
Most Billing Software Supported
🔒 100% confidential. We never sell your data. Privacy Policy
How We Help
Our Radiology Billing Expertise
Thrive manages the billing side of your radiology practice so your radiologists can stay focused on reading studies instead of chasing payers. That means applying modifier 26, TC, or global billing correctly on every study based on who owns the equipment and who performed the interpretation, sequencing multiple same-day studies for the professional component payment reduction, and routing advanced imaging authorization through the correct radiology benefit manager before the scan happens.
Practices that choose Thrive as their radiology medical billing company get a team that already knows component billing rules, RBM-specific authorization workflows, and interventional radiology’s mix of surgery and imaging codes, instead of a generalist biller treating every study the same way. Whether your practice is diagnostic imaging, interventional radiology, or teleradiology, the billing rules overlap enough to share one trained team and diverge enough that generalist billers consistently get them wrong.
HIPAA compliant
Certified Professional Coders
Nationwide Payer Coverage
95%+ clean claim rate across component, modality, and interventional claims submitted the first time
Claims out the door within 48 hours of a completed encounter
AR held under 30 days on average instead of aging past 60 or 90
Practices typically see a revenue lift approaching 30% after onboarding
Radiology Billing Outsourcing
End-to-End Radiologist Revenue Cycle Management
Radiology billing services carry a structural complexity most specialties do not, nearly every study can be billed three different ways depending on who owns the equipment and who read the images. Here is what we handle from the first eligibility check to the final payment.
Eligibility & Benefit Verification
Prior Authorization
Secures and tracks authorization for CT, MRI, PET, and other advanced imaging through the correct RBM, matched to the exact CPT code that will appear on the claim.
Claims Submission & Scrubbing
Checks every study for correct modifier 26, TC, or global billing, MPPR sequencing, and NCCI bundling before a claim leaves the building.
Denial Management & Appeals
Traces denials to their actual cause, whether a component modifier error or a missing RBM authorization, and appeals with the documentation each payer requires.
AR Follow-Up
Works open claims on a set schedule so high-volume imaging claims do not sit past 30 days unattended.
Patient Statements & Collections
Bills patients clearly for the portion insurance does not cover on advanced imaging and interventional procedures.
Payment Posting & Reconciliation
Reconciles payments against the expected professional or technical component rate, so underpayment gets caught early.
Credentialing & Payer Enrollment
Keeps radiologists credentialed and enrolled with the payers your patients actually carry, including facility-based and teleradiology arrangements.
Reporting
Regular reporting on claim status, denial trends, and AR aging broken out by modality and component type.
Radiology Billing Codes
Radiology CPT and HCPCS Coding Reference
A quick reference to how radiology billing codes are organized, not a substitute for chart documentation. Useful for seeing where a specific claim fits before it is coded.
- 70010 - 76499
Plain Film Radiography (X-Ray)
General diagnostic X-ray imaging across all body regions, the highest volume and lowest complexity radiology codes
- 70450 - 70498
CT, Head & Neck
Computed tomography of the brain, sinuses, orbits, and neck, coded by contrast status
- 71250 - 71275
CT, Chest
Computed tomography of the chest, including CT angiography protocols
- 72125 - 72159
CT, Spine
Computed tomography of the cervical, thoracic, and lumbar spine
- 74150 - 74178
CT, Abdomen & Pelvis
Computed tomography of the abdomen and pelvis, coded by contrast status and combined protocol
- 70551 - 70559
MRI, Brain
Magnetic resonance imaging of the brain, coded by contrast status
- 72141 - 72158
MRI, Spine
Magnetic resonance imaging of the cervical, thoracic, and lumbar spine
- 76700 - 76857
Ultrasound
Abdominal, pelvic, obstetric, and vascular ultrasound studies
- 77046 - 77067
Mammography
Diagnostic and screening mammography, including tomosynthesis and computer-aided detection
- 77080 - 77086
Bone Density (DXA)
Dual-energy X-ray absorptiometry for osteoporosis screening and monitoring
- 78012 - 79999
Nuclear Medicine & PET
Nuclear medicine studies and positron emission tomography for functional and metabolic imaging
- Interventional Radiology
Image-Guided Procedures
Catheter-based and percutaneous procedures billed with a combination of surgery-section and radiological supervision and interpretation codes
What is the difference between the professional and technical component?
Modifier 26 reports the professional component, the radiologist's interpretation and signed report. Modifier TC reports the technical component, the equipment, technologist, and facility cost required to acquire the images. When the same entity both owns the equipment and performs the interpretation, the code is billed globally with neither modifier. Billing both 26 and TC on the same claim line, or billing global when only one component was actually provided, is one of the most audited errors in radiology billing.
What is a radiology benefit manager and why does it matter for billing?
A radiology benefit manager, or RBM, is a third-party company such as eviCore, AIM Specialty Health, or Carelon that processes prior authorization for advanced imaging on behalf of most major commercial payers and Medicare Advantage plans. Each RBM applies its own clinical criteria and its own CPT code list, separate from the payer's general authorization rules, so confirming eligibility with the payer and confirming authorization with the correct RBM are two different steps.
Denial Patterns
What Can Put Radiology Claims at Risk
These are not generic billing problems. Each one is specific to how payers adjudicate component and modality-based imaging claims.
Modifier 26/TC Reversal or Omission
Billing the global code when only one component was provided, or reversing modifier 26 and TC, is one of the most common and costly radiology billing errors and is a documented audit pattern.
Wrong RBM Prior Authorization
Advanced imaging is routed through a radiology benefit manager such as eviCore, AIM, or Carelon rather than the payer directly, and authorization obtained through the wrong RBM or for the wrong CPT code does not cover the claim actually submitted.
MPPR Sequencing Errors
When multiple imaging studies are interpreted for the same patient on the same date, the professional component of the second and subsequent studies is reduced, and claims that do not sequence and flag studies correctly get paid incorrectly or denied on review.
Place of Service Mismatch on Component Claims
The place of service on a professional component claim has to reflect where the imaging was actually performed, not where the radiologist was physically located, and teleradiology arrangements make this error common.
Unbundling Against NCCI Edits
Billing imaging guidance, contrast administration, or a component study separately when the primary procedure code already includes it triggers an automatic NCCI denial.
Missing Medical Necessity Linkage
A study billed without an ICD-10 code that clearly supports the reason for the specific imaging ordered is denied regardless of how clinically appropriate the study actually was.
Interventional Radiology Coding Gaps
IR procedures combine surgery-section codes with radiological supervision and interpretation, and a coder unfamiliar with both code families consistently misses components or bundles them incorrectly.
Screening-to-Diagnostic Mammography Errors
A screening mammogram that becomes diagnostic after an abnormal finding requires modifier GG and correct sequencing, and claims that do not reflect the conversion get denied or underpaid.
Our Process
How We Manage Radiology Revenue
Every step below exists because of a specific denial pattern above. Nothing here is generic.
Eligibility & Prior Auth Clearance
We confirm coverage and route advanced imaging authorization through the correct radiology benefit manager for the exact CPT code before the study is scheduled.
Radiology-Trained Coding Review
Every claim is coded by billers who apply modifier 26, TC, or global correctly based on the equipment and interpretation arrangement for that specific study.
Pre-Submission MPPR & NCCI Scrubbing
Claims are checked for multiple procedure reduction sequencing and NCCI bundling edits before they reach a payer, catching the errors that cause the most denials.
Clean Claim Submission
Corrected claims go out within 48 hours, keeping your radiology billing cycle moving instead of sitting in a queue.
Denial Root-Cause & Appeal
Any denial is traced to its actual cause, a component modifier error, a missing RBM authorization, or an NCCI bundling issue, and appealed with the documentation that specific payer requires.
AR Follow-Up & Reporting
Outstanding claims are worked on a set follow-up schedule until resolved, with regular reporting back on where your numbers stand.
Why Thrive
Why Radiology Practices Choose Thrive
Practices that switch to Thrive get a radiology billing and coding company built around component logic and RBM authorization specifically, not generic revenue cycle coverage stretched across every specialty.
Radiology-Focused Coding Expertise
Coders who apply modifier 26, TC, and global billing correctly across every modality, not as one specialty among a dozen others.
HIPAA Compliance at Every Step
Patient data is handled under strict HIPAA safeguards across intake, coding, and reporting, regardless of practice size.
Nationwide Payer Experience
Claims experience across Medicare, Medicare Advantage, and commercial payers in all 50 states, not just regional plans.
Transparent, Regular Reporting
You get consistent visibility into claim status, denial trends, and AR aging, communicated directly by your billing team.
Audit-Ready Documentation
Coding and modifier decisions are documented in a way that holds up if a payer ever asks questions later, which matters most given how heavily component billing and MPPR sequencing get audited.
Talk to a Specialist
Talk to Our Radiology Medical Billing Experts
We will look at your current claim volume, denial patterns, and modality mix, advanced imaging heavy, interventional heavy, or general, and put together a custom fee schedule and a revenue recovery estimate. No obligation.
- Free 15-Minute Practice Revenue Review
- Custom fee schedule based on your claim volume and modality mix
- No disruption to your current documentation process
Request an Imaging Billing Review
Get a free no-obligation review of the billing steps behind your imaging claims, from order intake through payer follow-up.
🔒 100% confidential. We never sell your data. Privacy Policy
FAQ
Radiology Billing FAQs
How much does Radiology medical billing cost?
Fee structures are typically based on a percentage of collections and are set after we review your claim volume and modality mix, since a practice reading a high volume of advanced imaging bills very differently than one focused on plain film and ultrasound. You get a custom fee schedule after your Free 15-Minute Practice Revenue Review, with no obligation to sign anything.
How long does onboarding take?
Most radiology practices are fully onboarded within one to two weeks. We start with a free billing audit to see where claims are getting stuck, then align our coding and submission workflow to your current documentation process, with no disruption to your daily reading and reporting schedule during the switch.
Can you take over our existing AR and open claims?
Yes. We review your open AR, including anything already aged past 30 or 60 days, and prioritize the claims most likely to be recovered first. Older advanced imaging, mammography, and interventional radiology claims often still qualify for appeal well past their original denial date.
Do you bill technical and professional components separately?
Yes. Our coders apply modifier 26 for the professional component, modifier TC for the technical component, or bill the code globally when one entity provides both, based on exactly who owns the equipment and who performed the interpretation for that specific study.
How do you handle denied claims and appeals?
Every denial is traced back to its actual cause, a component modifier error, a missing RBM authorization, or an NCCI bundling issue, before we resubmit anything. We then file the appeal with the documentation that specific payer requires, rather than resending the same claim and hoping for a different result.
Is our patient data handled securely?
Yes. Patient data is handled under HIPAA safeguards across intake, coding, and reporting, and our billing team follows the same compliance standards regardless of practice size or claim volume.
How do we track our numbers?
You receive regular reporting covering claim status, denial trends, and AR aging, plus a direct line to your billing team any time you have a question about a specific claim. Nothing about your numbers lives in a black box you have to dig through yourself.
Do you work with radiology practices in every state?
Yes. Our team supports diagnostic radiology, interventional radiology, and teleradiology practices across all 50 states and works with Medicare, Medicare Advantage, and commercial payers nationwide. Your location does not change how thoroughly we work your claims or how quickly you get paid.
Free Revenue Analysis
Start With a Radiology Revenue Cycle Review
Want to see why imaging claims are slowing down? We will review your billing workflow, denial patterns, AR aging, payer issues, and reporting process, then outline practical opportunities to tighten follow-up and reduce avoidable delays.
- HIPAA Compliant
- Certified Billing & Coding Support
- Diagnostic & Procedure Claims
- Nationwide Support