Imaging Center Billing Services

An imaging center sells a service built from two parts: the scan and the read. How you bill those parts depends on who owns the equipment, who employs the radiologists, and what payers allow. Many centers bill globally, while others bill only the technical component and let a separate group bill the read.

Imaging center billing also depends on prior authorization, accreditation, and payer contracts. Westmont Revenue Partners connects imaging centers with vetted billing experts who know how to handle global and split claims, track authorizations, and manage denials across the revenue cycle.

Who this is for

• Freestanding imaging centers and independent diagnostic testing facilities
• Physician-owned MRI, CT, and ultrasound centers
• Breast imaging and screening centers
• Centers that contract with outside radiology groups
• Multi-site operators with mixed payer contracts

What gets billed

• Global claims for scans and interpretation
• Technical-only claims when another group reads the images
• Screening and diagnostic mammography
• MRI, CT, and ultrasound studies
• Low-dose CT lung cancer screening
• PET and PET/CT studies
• Bone density testing
• Contrast and supplies where payable
• Repeat or additional views when medically needed
• Self-pay and cash-price imaging

Commonly billed codes

Code	Type	What it covers
70553	CPT	MRI of the brain without then with contrast
72148	CPT	MRI of the lower spine without contrast
71271	CPT	Low-dose CT for lung cancer screening
77067	CPT	Screening mammography, both breasts, with computer-aided detection
78815	CPT	PET with CT, skull base to mid-thigh
TC	Modifier	Technical component only: equipment, technologist, and supplies
26	Modifier	Professional component only: the interpretation and report
No modifier	Billing format	Global claim when one entity owns the equipment and interprets the study

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in imaging centers

Professional vs. technical component billing. Imaging centers usually choose between two models.

• Global billing. The center owns the equipment, employs or contracts the radiologist, and bills one claim for both parts.
• Split billing. The center bills the technical component with TC, and a separate radiology group bills the professional component with modifier 26.

Contracts, enrollment, and payer rules decide which model is allowed. Medicare generally requires enrollment as the correct supplier type, and independent diagnostic testing facilities have specific enrollment rules. Billers confirm your setup before the first claim.

• Choosing global or split claims. The wrong format creates denials or double billing. Billers match the claim to your ownership and radiologist arrangement.
• Prior authorization. Many payers require approval for MRI, CT, and PET before the scan. Billers verify authorization at scheduling and keep the number on the claim.
• Multiple imaging reductions. Medicare generally reduces the technical component for additional advanced studies in the same session. Billers model these reductions to catch underpayments.
• Supplier enrollment. Independent diagnostic testing facilities must follow Medicare enrollment standards. Billers track enrollment, locations, and changes in ownership.
• Accreditation requirements. Some payers and Medicare require accreditation for advanced imaging. Billers confirm status is on file with each payer.
• Order and clinical data. A missing or unclear order leads to denials. Billers check that orders are complete before scans are done.
• Cash and self-pay pricing. Cash prices and patient estimates need clear policies. Billers follow price transparency rules and apply them consistently.

How Westmont can help

• Matching you with vetted billing experts experienced in imaging center billing
• End-to-end revenue cycle support, from verification to payment posting
• Denial management for authorization and modifier problems
• Credentialing and payer enrollment help
• Reports by modality, payer, and site

Frequently asked questions

Should our imaging center bill globally or split the claim?

If you own the equipment and employ or contract your radiologists in a way that payers recognize, global billing is often allowed. If another group reads the studies, you generally bill the technical component only. Check payer contracts and enrollment before choosing.

What is an independent diagnostic testing facility?

It is a Medicare category for a facility that performs diagnostic tests apart from a hospital or physician office. It has its own enrollment standards and supervision rules. Not every imaging center needs this status, so confirm your classification with your MAC.

Why does Medicare pay less for the second scan on the same day?

Medicare applies a multiple-procedure reduction to advanced imaging in one session. The first technical component is paid in full and later ones are reduced. Commercial payers may use similar rules. A biller can compare each payment to the expected amount.

Do we need prior authorization for every MRI and CT?

Not always. Many payers require it for advanced imaging, and some use outside vendors. Rules differ by plan and change often. Build authorization checks into scheduling so patients are not scanned before approval.

How do we bill low-dose CT lung cancer screening?

Use the code set and diagnosis rules that apply to the payer. Medicare has specific eligibility and counseling requirements for this service. Check current coverage policy before scheduling patients, and confirm that referring providers meet documentation rules.

Related billing services

• Radiology Billing
• Teleradiology Billing
• Nuclear Medicine Billing
• Mobile Diagnostic Billing
• Ambulatory Billing