MedicaidBilling CodesHigh impact
Billing Requirements for Diagnostic Services
Illinois Medicaid - HFS·IL · Radiology, Cardiology, Pulmonology +2 more·Provider Notice
Effective date
Jul 2, 2004
We identified it
Jun 21, 2026
Summary
For diagnostic procedures, providers must now submit both modifier 26 (professional component) and TC (technical component) when billing for global reimbursement. Different submission requirements apply based on claim type (paper, NSF electronic, or HIPAA 837P electronic).
Action Required
Immediately: Billing team must update procedures to submit both modifier 26 and TC for all diagnostic procedure global billing. For paper claims: report procedure code with modifier 26 on one line and same code with modifier TC on another line. For NSF electronic claims: report both modifiers 26 and TC in Claim Detail. For HIPAA 837P electronic claims: report both modifiers in Loop 2400. Update billing software rules and train staff on new modifier requirements.