Modifier code
Modifier 26: Professional component
Splits a procedure into its professional (physician interpretation) and technical (facility) components.
Code
26
When to use
When billing for the interpretation/professional portion of a service like radiology, EKG, or PFTs separately from the facility fees.
Common issues
- Bundled if no TC counterpart billed by facility
- Used to split global vs split-fee billing
Frequently asked questions
What is modifier 26?
Professional component
When should it be used?
When billing for the interpretation/professional portion of a service like radiology, EKG, or PFTs separately from the facility fees.
Common issues when modifier is missing or wrong?
Bundled if no TC counterpart billed by facility; Used to split global vs split-fee billing.
Other modifiers
- 25 — Significant, separately identifiable E&M service on same day as procedureWhen E&M visit + procedure happen same day and the E&M was separately documented
- 50 — Bilateral procedureProcedure performed on both sides of the body during a single session.
- 51 — Multiple proceduresMultiple procedures performed at the same session.
- 52 — Reduced servicesService partially reduced or eliminated at the physician's discretion.
- 53 — Discontinued procedureProcedure discontinued because of extenuating circumstances.
- 57 — Decision for surgeryE&M visit at which decision for major surgery was made.
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