Modifier 26 is defined as the professional component (PC).
The PC is outlined as a physician's service, which may include technician supervision, interpretation of results and a written report.
Use modifier 26 when a physician interprets but does not perform the test.
Most radiology codes, including ultrasounds, x-rays, CT scans, magnetic resonance angiography, and magnetic resonance imaging, may be billed with modifier 26 or TC, or with no modifier at all, indicating that the provider performed both the professional and technical services.
This modifier must be reported in the first modifier field.
Add modifier 26:
When billing only the professional component portion of a test
To report the physician's interpretation of a test
Procedures that have a "1" in the Professional Component (PC)TC field on the Medicare Physician Fee Schedule Database (MPFSDB)
Procedures falling into the following types of service:
1 - Medical Care/Injections
2 - Surgery
4 - Radiology
5 - Lab
6 - Radiation Therapy
8 - Assistant Surgeon
Do not add Modifier 26 to:
Evaluation and management (E/M) or anesthesia codes
Procedure or service descriptors that indicate professional component only
Global test only codes, example: CPT 93000.
Professional component only codes. PC/TC indicator 2 of MPFSDB denotes a professional component only code that identifies stand-alone codes.
An example of a professional component only code is 93010, Electrocardiogram; interpretation and report. Modifier 26 cannot be used with this code.
Re-read results of an interpretation provided by another physician.