This applies to both Commercial and Medicaid Expansion
Most radiology services (including but not limited to mammography services) consist of two components: professional component (PC) and technical component (TC). Blue Cross Blue Sheild of North Dakota (BCBSND) recognizes the Medicare Physician Fee Schedule (MPFS) for billing radiology services. Billing for these services is indicated with a PC/TC indicator of "1" on the MPFS.
Aligning with Medicare and other payers, we recommend billing the:
- technical component on the date the test is performed
- professional component either on the date of interpretation or the date of the test, depending on whether a global service was provided
If not billing globally or the respective dates for billing differ, bill the:
- technical component on the service date
- professional component on the interpretation date
Questions?
We can help. Contact the appropriate Provider Service Center:
- Commercial: 800-368-2312
- Medicaid Expansion: 833-777-5779
