Teleradiology Billing Services

Teleradiology groups read studies from a distance, often for many hospitals, emergency departments, and imaging centers at once. That creates billing issues a local reading group does not have. Each client site has its own contract, its own patient registration process, and sometimes its own rules on who bills the payer.

Most teleradiology revenue is the professional component, and the images belong to someone else. Westmont Revenue Partners connects teleradiology groups with vetted billing experts who understand professional component billing, multi-state enrollment, and contract-driven workflows, and who can support the full revenue cycle.

Who this is for

• Teleradiology groups reading for hospitals and emergency departments
• Radiologists who work remotely for a mix of clients
• Groups providing overnight, weekend, or subspecialty reads
• Practices with radiologists licensed in several states
• Groups that bill payers directly and groups paid by facility contract

What gets billed

• Professional interpretation of CT, MRI, X-ray, and ultrasound studies
• Preliminary and final reads
• PET and nuclear imaging interpretation
• Mammography interpretation where a client site requests it
• Over-reads and second opinions
• Stat and after-hours coverage under facility contracts
• Subspecialty reads in neuro, body, or musculoskeletal imaging
• Addenda and corrected reports
• Contracted per-read or per-shift fees to client facilities

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
78816	CPT	PET with CT, whole body
26	Modifier	Professional component only, the usual modifier for remote reads
TC	Modifier	Technical component, billed by the party that owns the equipment

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 teleradiology

Professional vs. technical component billing. A teleradiology group does not own the scanner, so it generally bills only the professional component, using modifier 26. The hospital or imaging center that owns the equipment bills the technical side, or bills globally if it employs the reader. Some arrangements instead have the client facility bill and pay the group by contract. Billers confirm the arrangement for each client, because Medicare and other payers have rules about who may bill for purchased interpretations. Check current rules for your setup.

• Many client contracts. Each client may require different billing, reporting, and turnaround steps. Billers keep a contract matrix and set up rules in the billing system per site.
• Getting complete patient data. Demographics and insurance often come from the client site. Missing data delays claims. Billers set up feeds or portals and chase gaps.
• Payer enrollment in each state. Radiologists may need to be enrolled and licensed where the patient is. Billers track credentialing by state and payer.
• Purchased interpretation rules. Medicare has rules about who may bill for interpretations that are purchased from another party. Billers review each arrangement with your counsel and keep contracts current.
• Preliminary versus final reads. Usually only the final report is billable. Billers confirm that final interpretations are complete before charges are posted.
• Out-of-network risk. Patients may be seen at facilities where the group is not in network. Billers follow current federal and state rules on surprise billing and payment disputes, and monitor for updates.
• Reconciling volume. Studies must match between the client system and your records. Billers reconcile read lists with charges to prevent missed revenue.

How Westmont can help

• Matching you with vetted billing experts experienced in teleradiology
• End-to-end revenue cycle support, from charge capture to payment posting
• Denial management, including enrollment and eligibility denials
• Credentialing support across multiple payers and states
• Reporting by client site, payer, and study type

Frequently asked questions

Do teleradiology groups bill the technical component?

Usually not. The group reads images made on equipment owned by someone else, so it generally bills the professional component with modifier 26. The facility that owns the scanner bills the technical side. Some contracts instead have the facility bill and pay the group directly.

Is teleradiology billed as a Medicare telehealth service?

Medicare treats radiology interpretations differently from standard telehealth visits. They are not billed with typical telehealth modifiers or place-of-service rules for visits. Other payers may differ. Confirm each payer's policy and check current-year guidance before building your billing workflow.

What is a preliminary read and can it be billed?

A preliminary read is an early interpretation, often by a resident or on-call reader, that is later replaced by a final report. Payers generally pay only for the final interpretation. Make sure your charge process posts charges at final sign-off.

Which state licenses and enrollments do we need?

Radiologists generally must be licensed where the patient is located, and payers may require enrollment by state. Rules vary, so check each state board and payer. A biller can track expiration dates and prevent gaps that cause denials.

How do we handle claims for several hospital clients?

Use a contract matrix that shows how each client wants billing handled, including who bills, which payers apply, and what data they will send. Reconcile each month so that studies read match charges posted.

Related billing services

• Radiology Billing
• Imaging Center Billing
• Interventional Radiology Billing
• Emergency Medicine Billing
• Telemedicine Billing