Radiology billing for groups and imaging centers: professional interpretations for hospitals and other sites, global and technical billing for the equipment you own, CT, MRI, ultrasound and nuclear medicine, mammography, and the authorizations advanced imaging needs, worked inside the software you already use by a US-based team.
Radiology billing services turn every study into a paid claim. Each exam is billed as the reading, the equipment or both, depending on who owns what, coded to the views, contrast and sides in the report, and checked against the order and the authorization, and every payment, denial and patient balance is followed until it is resolved.
$261M
in improper Medicare payments to diagnostic radiology in CMS’s 2025 review, a 5.8% improper payment rate
99.9%
of those diagnostic radiology errors were missing or insufficient documentation, not incorrect coding
Radiology bills one exam in up to three pieces. The interpretation is the professional component, the equipment, staff and supplies are the technical component, and a practice that does both bills the global service. Who owns the machine and where the patient was decides which piece you bill. Add Medicare’s reduction for several studies in one session, screening exams that turn diagnostic, contrast billed by volume and advanced imaging that needs authorization, and the order and the report decide most claims.
The order, the report and the site decide the claim. That is why we check the ordering provider, the views and contrast documented, the place of service and the authorization on every study before it goes out, not after it is denied.
Most radiology groups bill professional reads, global or technical studies and mammography in the same week, often across several facilities. Each one pays differently and fails in its own way. Here is where each breaks, and what we do about it.
Pays forInterpretations of CT, MRI, X-ray, ultrasound and nuclear medicine studies done at hospitals, surgery centers and other sites.
Where it breaks
What we do
Pays forStudies done on equipment your practice owns, billed globally, or as the technical component when another physician reads them.
Where it breaks
What we do
Pays forScreening and diagnostic mammograms, breast tomosynthesis and breast ultrasound.
Where it breaks
What we do
Every imaging study has two parts. The technical component (modifier TC) covers the equipment, the technologist and the supplies; the professional component (modifier 26) covers the radiologist’s interpretation and report. A practice that owns the equipment and reads the study bills the global service, with no modifier. A radiologist reading a hospital or surgery center study bills only the professional component, because the facility bills the technical part.
When several CT, MRI or ultrasound studies are done in one session, Medicare reduces the payment for all but the most expensive. For the same patient on the same day, the technical component of each additional study is paid at 50%, and when the same physician or group reads them, the professional component of each additional study is paid at 95%. Medicare also requires an order from the treating provider for each diagnostic test, so a missing or mismatched order puts the whole claim at risk.
What we do: before a study is billed, we confirm who owns the equipment and where it was done, apply 26, TC or global billing to match, and check the order and the authorization. We set each session’s expected payment with the multiple procedure reductions applied, so underpayments stand out and are appealed.
These are the codes behind many radiology claims, and what payers look for on each one. Commercial plans and their radiology benefit managers add their own authorization rules, and we check each one.
| Code | What it covers | What payers look for |
|---|---|---|
| 7045074177 | CT of the head without contrast, and CT of the abdomen and pelvis with contrast | The contrast stated in the report; authorization from many plans. |
| 7055372148 | MRI of the brain without and with contrast, and MRI of the lumbar spine without contrast | Authorization, the contrast used, and the reason on the order matching the report. |
| 71046 | Chest X-ray, two views | The number of views in the report matches the code. |
| 7670076705 | Abdominal ultrasound, complete and limited | Complete only when every required organ is documented; otherwise limited. |
| 77067 | Screening mammogram, both breasts | Medicare's frequency rules; no deductible or coinsurance. |
| 7706577066 | Diagnostic mammogram, one or both breasts | GG on the Medicare claim when a screening the same day became diagnostic. |
| 77063G0279 | Breast tomosynthesis add-on, screening and diagnostic | 77063 with a screening mammogram; G0279 with a diagnostic one for Medicare. |
| 78815 | PET/CT, skull base to mid-thigh | Authorization and the coverage indication for the cancer being staged or followed. |
| Q9965 to Q9967A9575 to A9585 | Contrast agents for CT and MRI | Billed by the amount used, with the code for the agent documented. |
The interpretation and report, for studies on equipment you do not own.
The equipment, technologist and supplies, when another physician reads the study.
Medicare: a screening and a diagnostic mammogram on the same patient on the same day.
The same study repeated on the same day by the same physician, such as a follow-up chest X-ray.
The same study repeated on the same day by a different physician.
A study with fewer views or less than the code describes, when no limited code exists.
Sources: Medicare Claims Processing Manual, chapter 13 (radiology services) and chapter 18 (preventive services, screening mammography); 42 CFR 410.32; Medicare NCCI Policy Manual, chapter IX (radiology services). CPT is a registered trademark of the American Medical Association; the descriptions above are summaries. Reviewed October 2026.
It is not for every practice. If you are a hospital-employed group whose billing the hospital handles, you do not need us. And if your in-house team keeps denials low and receivables current, keep them, and consider a periodic billing audit instead.
We look at your clean-claim rate, your denials by payer and reason, component billing, orders and authorizations, multiple procedure reductions, and your aging receivables, and tell you what we find, whether or not you go further with us.
We get access to your practice management system and clearinghouse, load each payer's authorization and bundling rules and your fee schedules, list each facility you read for and its open authorizations, and agree how escalations work. Most practices are live within one to two weeks.
Studies are coded and claims submitted within 24 hours. Rejections are corrected the same day, remittances posted as they arrive, components, orders and authorizations checked, and denials worked to their cause, all inside your system.
A report you can read in ten minutes: what was billed and collected by payer, site and service line, what was denied and why, authorizations pending, and what is aging.
You do not change systems to work with Summit Billing Solutions. We work in the practice management and EHR systems below, and through the clearinghouse you already use. If your EHR is not shown, ask; the list grows as we onboard practices.
2%
Average claim rejection rate
24 hrs
Claims submitted within
28
Average days in A/R
Not only have they helped us streamline our operations, but their expertise has also maximized our revenue cycle, allowing us to focus more on patient care. The level of communication is outstanding; we always feel informed and supported.
Their organization and communication skills are impressive, allowing for effective and efficient collaboration.
Most billing companies charge a percentage of what they collect; some charge a flat monthly fee or a per-claim rate. For a radiology group, a percentage usually fits best: the company is paid when you are paid, so the incentive sits where it belongs.
Summit Billing Solutions charges between 3% and 9% of monthly collections. What moves the number for a radiology group is the mix of professional and global billing, study volume, how many facilities you read for, authorization volume, and how clean the receivables are when we take them on, which is why we quote your exact rate after the free account review, not before.
3% to 9%
of monthly collections
We bill for more than 40 specialties, for practices in all 50 states, from Salem, New Hampshire. Each one has its own codes, modifiers and payer rules.
Chiropractic billing
Family practice billing
Pediatric billing
Urgent care billing
Ophthalmology billing
Mental health billing
Psychiatry billing
Cardiology billing
Gastroenterology billing
Urology billing
Neurology billing
Dermatology billing
Pain management billing
Pulmonology billing
Podiatry billing
Oncology billing
Orthopedic billing
OB/GYN billing
Telemedicine billing
All 40+ specialties
A free account review looks at your clean-claim rate, your denials by payer and reason, component billing, orders, authorizations and multiple procedure reductions, and your aging receivables, and tells you what we would change. No cost, no obligation, and no pressure to continue. What the review covers, step by step, is on the free account review page.
50A Northwestern Drive, Salem, NH 03079
603-207-3172
(866) 906-3116
info@summitbillingsolutions.com
Mon - Fri @ 9am - 5pm
Billing can easily become stressful and overwhelming, but with their team, the entire process feels organized, manageable, and under control.