When is modifier -26 used?

• A. To bill the professional component of a service separately from the technical component.
• B. Denotes the technical component of a service.
• C. To indicate telemedicine payment only.
• D. For bundled payments of multiple procedures.

Answer: (A)

Modifier -26 is used to bill for the professional component of a service separately from its technical component. In imaging and similar procedures, the technical component covers the actual performance of the procedure with the equipment, while the professional component covers the physician’s interpretation and report. When the physician provides only the interpretation (and the facility performs the imaging), the professional component is billed by attaching -26 to the CPT code for the service. The technical component would be billed separately with the -TC modifier, or included in the facility’s charge as appropriate. This modifier is not for telemedicine payments and not used to indicate bundled payments.