Radiology Billing Services
Radiology billing services are specialty billing and revenue cycle services built specifically for imaging providers where a study billed global when it should have been the professional component only, or a high-cost MRI performed without a prior authorization on file, is the difference between a fully-paid study and revenue that leaks a few dollars or a whole claim at a time across thousands of reads.
EverCure Billing handles the complete revenue cycle for radiology practices, imaging centers, and interventional radiology groups across the United States: prior authorizations, eligibility checks, component-accurate coding, claim submission, denial appeals, and aged A/R recovery. Your radiologists read the studies. We make sure the interpretation, the technical work, and the imaging-guided procedures you already performed actually get paid split correctly, authorized correctly, and holding up if a payer looks. That also means your front desk and techs aren't buried under authorization work when volume spikes.
What Are Radiology Billing Services?
Radiology billing services cover every financial step between an ordered study and that money landing in your practice account.
For a radiology practice specifically, that includes securing the prior authorization before a high-cost study is performed, verifying benefits, coding each study with the correct CPT, ICD-10, and modifier combination including the professional-versus-technical component split, the contrast distinction, laterality, and the supervision-and-interpretation codes that pair with interventional procedures submitting a clean claim, posting the payment, appealing the denial when the payer pushes back, and chasing the balance until it clears.
General medical billing stops at "submit the claim." Radiology billing runs on professional/technical component discipline (modifiers 26 and TC), heavy prior-authorization gating through radiology benefit managers, contrast and modality coding, laterality, interventional supervision-and-interpretation, and medical-necessity rules under payer LCDs. Because read volume is so high, a wrong component or a missed authorization repeats across thousands of studies. That combination makes radiology one of the easiest specialties to under-bill or outright deny without seeing it happen.
Why Do Radiology Practices Lose More Revenue Than Other Specialties?
Because imaging revenue depends on getting the component split, the authorization, and the modality coding exactly right on every study and the volume means one repeated mistake becomes serious money fast. These are the specific leaks we see when we run audits on radiology practices:
Professional / technical / global component errors (26 and TC)
This is the leak that defines radiology. If the radiologist only interprets the study, you bill the professional component (modifier 26); the facility bills the technical component (TC); billed together it's global. Bill global when you should bill 26-only and the claim denies or gets clawed back later. Miss the split entirely and you're paid for a fraction of the work.
Prior authorization failures
High-cost imaging MRI, CT, PET, nuclear medicine is heavily gated through payers and radiology benefit managers. No authorization on file is an automatic denial, and it is often unrecoverable after the study is already performed. Front-end authorization discipline is where a lot of radiology revenue is saved or lost before a claim is ever built.
Contrast and modality coding
"Without contrast," "with contrast," and "without and with contrast" are different codes, and contrast material and supply codes bill separately. Miss the contrast distinction or drop the supply code and the study underpays every time it happens.
Laterality and bilateral coding
Imaging is full of paired anatomy. Miss the bilateral modifier or the correct laterality and only one side gets paid.
Interventional radiology bundling and supervision-and-interpretation
IR procedures pair a procedure code with supervision-and-interpretation and imaging-guidance codes. Drop the S&I component, or let legitimately separate services bundle under NCCI edits, and high-dollar procedure revenue quietly disappears.
Medical necessity and diagnosis linkage
Imaging denies on medical necessity when the ordering diagnosis doesn't support the study under the payer's coverage rules (LCDs). Under-specified or mislinked ICD-10 coding turns clean-looking claims into denials.
We build the workflow around these six failure points, because they are where radiology revenue actually disappears.
What Radiology Billing Services Does
EverCure Billing Provide?
Prior authorization management
We secure authorizations for high-cost imaging before the study is performed, work directly with payers and radiology benefit managers, attach the required clinical documentation, follow up until a decision is issued, and track expiry dates so approvals don't lapse before the study date. In radiology this is front-line revenue protection, not a back-office task.
Insurance eligibility and benefits verification
We verify active coverage, plan type, deductible status, coinsurance, and imaging-specific benefit limits before the study so imaging isn't performed on a claim that was never going to pay the way the practice assumed.
Radiology medical coding
Our coders work from the report to assign the correct CPT, ICD-10-CM, and HCPCS codes applying the professional/technical component split, contrast and modality logic, laterality, interventional supervision-and-interpretation, and diagnosis-to-study linkage so claims clear medical-necessity edits. Coding and billing are handled together, so coding errors are caught before the claim goes out, not after it's audited.
Charge entry and claim scrubbing
Every claim runs through a pre-submission check for payer-specific edits, component modifiers (26/TC), contrast and supply codes, laterality, NCCI bundling, and LCD medical-necessity rules before it leaves our office.
Claim submission and clearinghouse management
Electronic submission, rejection handling at the clearinghouse level, and same-day correction and resubmission on front-end rejects.
Payment posting and reconciliation
ERA and manual EOB posting, contractual adjustment verification, and underpayment identification including multiple-procedure payment reduction (MPPR) checks, because across imaging volume most practices never catch when a study is paid below the contracted rate.
Denial management and appeals
Every denial is categorized by root cause component, authorization, medical necessity, bundling corrected, and appealed with the supporting documentation the payer is actually asking for. We also feed denial patterns back into coding and authorization so the same denial stops repeating.
Accounts receivable follow-up and recovery
Structured follow-up on aged claims by bucket (30 / 60 / 90 / 120+ days), with priority given to higher-dollar interventional claims and anything approaching a timely filing deadline.
Patient billing and support
Clear patient statements, balance explanations, and a support line so your front desk isn't spending its day explaining imaging deductibles and coinsurance.
Provider credentialing and payer enrollment
New radiologist enrollment, re-credentialing, CAQH maintenance, reassignment for teleradiology, and Medicare and Medicaid enrollment so a new reader in your group isn't sitting idle waiting on a payer panel.
Billing audits and compliance review
Periodic internal review of component accuracy, contrast coding, laterality, mammography frequency rules, and interventional coding to reduce audit exposure before a payer finds it first with audit-defense documentation prepared for high-scrutiny codes.
Financial reporting
Monthly reporting on collections, clean claim rate, denial rate by reason, days in A/R, and payer performance in plain language, not a data dump.
Which Radiology Services
Do You Bill?
Diagnostic X-ray / radiography General radiography across body regions, coded to view count and anatomy.
Computed tomography (CT) CT studies coded to region and contrast status, including combined abdomen-and-pelvis coding.
Magnetic resonance imaging (MRI / MRA) MRI and MR angiography coded to region and contrast status.
Ultrasound and Doppler Diagnostic ultrasound, OB ultrasound, and vascular Doppler studies coded to type and completeness.
Mammography Screening, diagnostic (unilateral/bilateral), and 3D tomosynthesis coded to type with the correct frequency rules.
Nuclear medicine and PET Nuclear studies and PET/PET-CT coded with radiopharmaceutical supply codes captured.
Fluoroscopy Fluoroscopic studies and guidance coded correctly.
Bone density (DEXA) Bone density scans coded to indication and frequency.
Interventional radiology Image-guided biopsies, drainages, angiography, embolization, and related procedures coded with their supervision-and-interpretation and guidance components.
Contrast studies With/without/with-and-without contrast studies coded correctly, with contrast material and supply codes billed separately.
Which Radiology CPT and ICD-10 Codes
Do You Work With?
| Code Range | What It Covers |
|---|---|
| 71045–71048 | Radiography of the chest (X-ray) |
| 70450, 70460, 70470 | CT head/brain (without / with / without and with contrast) |
| 74176–74178 | CT abdomen and pelvis |
| 70551–70553 | MRI brain |
| 72141–72158 | MRI spine |
| 76700–76776 | Diagnostic ultrasound (abdomen, retroperitoneal, etc.) |
| 76801–76817 | Obstetric ultrasound |
| 93880–93990 | Vascular / Doppler ultrasound studies |
| 77065–77067 | Mammography (diagnostic unilateral/bilateral, screening) |
| 77080 | Bone density study (DEXA) |
| 78012–78999 | Nuclear medicine studies |
| 78811–78816 | PET / PET-CT imaging |
| 77002, 77012, 77021 | Imaging guidance (fluoroscopic / CT / MRI) |
| 10004–10012 | Fine needle aspiration biopsy with guidance |
| 36000–37799 | Vascular and interventional procedures |
| Q9958–Q9969, A9500– | Contrast agents and radiopharmaceutical supply codes |
| Z12.31 | Encounter for screening mammogram |
| R07.9 | Chest pain, unspecified |
| R10.- | Abdominal and pelvic pain |
| M54.- | Dorsalgia (back pain) |
| R51.- | Headache |
Code sets update annually and payer rules including component billing, prior-authorization policy, LCD medical-necessity criteria, and MPPR update more often than that. Keeping current on both is part of the service, not an extra.
Which Modifiers Actually Decide Whether
a Radiology Claim Gets Paid?
Professional component. The radiologist's interpretation only, when the practice doesn't own the equipment. This is the modifier radiology lives on.
Technical component. The equipment, supplies, and technician work, billed by the facility that owns the machine. No modifier at all means the global service (both components).
Bilateral and laterality, so paired imaging and procedures are reported and paid on both sides.
Distinct procedural service, used to correctly separate legitimately separate services under NCCI bundling edits.
Repeat procedure by the same or a different physician, common when a study is repeated the same day.
Reduced services, when a study is partially performed.
Discontinued procedure, when a study is stopped after it begins.
Multiple procedures in the same session, so reduction logic is applied correctly.
Increased procedural services, for unusually complex interventional work.
Service performed in part by a resident under a teaching physician, for academic and hospital-based practices.
How Does Compliance Work in Radiology Billing?
Component billing accuracy
The professional/technical/global split has to be right on every study, matched to who owns the equipment and who performed the read. We build that logic into every claim so the practice is paid for exactly what it did no duplicates, no under-billing.
Prior authorization and medical necessity
High-cost imaging is gated by authorization and by LCD medical-necessity rules. We secure authorizations up front and link the correct supporting diagnosis so studies pay instead of denying after the fact.
Mammography frequency and screening rules
Screening and diagnostic mammography carry frequency and documentation rules. We apply them so screening studies aren't denied as too-frequent or mislabeled.
Interventional coding integrity
IR bundling and supervision-and-interpretation rules are complex and audited. We code the procedure, guidance, and S&I components correctly and hold them to the documentation standard.
HIPAA and data security
Every EverCure Billing team member works under signed HIPAA agreements with role-based access to PHI, secure data transfer, and no PHI on personal devices or unsecured channels.
How Does
Onboarding Work?
Free billing audit
We review a sample of recent claims, denials, and your aged A/R to identify where revenue is being lost component errors, missed authorizations, contrast and laterality gaps and how much of it is recoverable.
Findings and scope
You get a written summary of what we found and a clear proposal services, pricing, and timeline. No obligation to continue.
System access and setup
We work inside your existing RIS, PACS, and billing system. No migration, no software purchase, no disruption to your reading workflow.
Workflow mapping
We document your modality mix, top payers, authorization requirements, current denial patterns, and internal handoffs, then build the billing workflow around how your practice actually runs.
Go live
Claims start flowing through our process. In parallel, we begin working your existing aged A/R old money is usually the fastest win.
Ongoing reporting and review
Monthly financial reporting, a dedicated account manager, and a scheduled review call to go through what's working and what needs to change.
Typical onboarding runs about two to four weeks depending on system access and practice size.
Which EHR, RIS, and PACS Systems
Do You Work In?
We work directly in your current systems rather than asking you to change platforms. Our team has worked across common RIS and PACS environments and billing platforms including eClinicalWorks, AdvancedMD, NextGen, athenahealth, Kareo/Tebra, CareCloud, Epic, and Cerner, alongside radiology-specific RIS/PACS setups.
If your system isn't listed, tell us which one you use in most cases we can be trained and productive in it within days.
Who Do We Work With?
We serve practices nationwide, with a growing footprint in Indiana and New Jersey.
What Does Radiology Billing Cost?
Our radiology billing services are priced as a percentage of monthly collections so our revenue only grows when yours does. Your exact rate depends on modality and procedure mix, monthly study volume, whether you bill professional, technical, or global, payer mix, and which parts of the cycle you want us to handle.
There are no setup fees and no long-term lock-in contracts. If you want a specific number, the free audit is the fastest way to get one that's accurate rather than generic.
Why Choose EverCure Billing for Radiology Billing?
We get the component split right.
In radiology, the professional/technical/global decision drives whether you're paid correctly on every study. Handling coding and billing in one workflow means that split and the modifiers around it is checked before the claim drops, not corrected after a clawback.
We protect revenue at the front end.
Prior authorization is where radiology money is most often lost. We secure and track authorizations up front so studies don't get performed and then denied.
We work the high-volume detail.
Component modifiers, contrast coding, laterality, and interventional S&I take real attention across thousands of studies. That's the work we don't cut corners because the volume is high.
You get a named account manager, not a ticket queue.
One person who knows your practice, your modalities, and your payers, reachable directly.
Direct access to leadership.
When something goes wrong, you're not escalating through four layers to get an answer.
Denial data goes back into coding and authorization.
Every denial reason is tracked and fed back upstream so the same error stops repeating. Most billing companies just resubmit.
Transparent reporting.
You see clean claim rate, denial rate by reason, days in A/R, and collections every month, explained clearly.
No long-term contracts.
We keep your business by performing, not by locking you in.
Is Your Radiology Practice Leaving Money on the Table?
Most imaging practices don't know how many studies are billed on the wrong component, how many high-cost scans are denying for missing authorization, how much contrast and supply revenue is going uncoded, or how much of their aged A/R is still collectible until someone actually looks.
That's what the free audit is for. We review your recent claims, denials, and A/R and give you a written breakdown of what's recoverable and what's causing the leak. No cost, no obligation.
Frequently Asked Questions
About Radiology Billing
Yes. The component split is the core of radiology billing. We code each study to who owns the equipment and who performed the read professional-only, technical-only, or global so you're paid for exactly what you did without duplicates or clawbacks.
Yes. High-cost imaging is heavily authorization-gated through payers and radiology benefit managers, and a missed authorization is usually an unrecoverable denial. We secure and track authorizations up front, before the study is performed.
Yes. We code IR procedures with their supervision-and-interpretation and imaging-guidance components and hold the bundling to NCCI rules, so high-dollar procedure revenue isn't lost to missing S&I or incorrect bundling.
Yes. Without/with/with-and-without contrast are distinct codes, and contrast material and supply codes bill separately. We capture the correct study code and the supply so the study doesn't underpay.
Yes. We log into your current systems and work inside them. There is no software to buy and no migration required.
Both. Aged A/R is usually where the fastest recovery is available, so we start working it in parallel with new claim submission.
Yes. We apply Medicare and Medicaid coverage, LCD medical-necessity, timely-filing, and MPPR rules so imaging claims pay correctly.
Yes. New radiologist enrollment, re-credentialing, CAQH maintenance, teleradiology reassignment, and Medicare and Medicaid enrollment are all available, either bundled with billing or as a standalone service.
All work is performed under signed HIPAA agreements with role-based PHI access, secure transfer methods, and no PHI stored on personal devices.
Start with the free billing audit. You'll get a written picture of where your revenue is leaking before you commit to anything.
Ready to Fix Your Radiology Revenue Cycle?
Every mis-split study and every aged account is money your practice already earned. Let's go get it.
📧 info@evercurebilling.com⚠️ Fill these in before publishing
• Pricing percentage decide whether to state your % range publicly or keep it quote-only. Right now it's quote-only.
• Certifications if/when you have AAPC-certified coders or HIPAA/ISO documentation, add a short certifications block. Don't claim it before it's true.
• Testimonials / case study leave this section out until you have a real radiology client who agrees to be quoted. An empty or fake one costs more trust than it gains.