MedicaidBilling CodesMedium impact
Clarification on Billing Requirements for Diagnostic Services
Illinois Medicaid - HFS·IL · Radiology, Cardiology·Provider Notice
Effective date
Sep 1, 2004
We identified it
Jun 21, 2026
Summary
Effective September 1, 2004, providers no longer need to bill both TC and 26 modifiers for global diagnostic service reimbursement. Claims without modifiers will receive global payment, while claims with modifier 26 or TC will receive component-only reimbursement.
Action Required
Immediately: Billing team must review all diagnostic service claims submitted since September 1, 2004. For claims incorrectly billed globally when only technical or professional component was provided, complete adjustment forms to void incorrect claims and resubmit for proper component billing with appropriate TC or 26 modifiers. Update billing procedures to bill diagnostic codes without modifiers only when providing complete global service.