CommercialBilling CodesHigh impact
03.00.20t, Modifiers 26 (Professional Component) and TC (Technical Component)
Independence Blue Cross·Radiology, Pathology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Policy 03.00.20t addresses the use of CPT modifiers 26 (Professional Component) and TC (Technical Component) for billing purposes, effective January 1, 2025. This policy clarifies when and how these modifiers should be applied to diagnostic and procedural codes to ensure proper component-based billing and reimbursement.
Action Required
By February 28, 2025: Billing team must review and implement modifier 26 and TC application rules in billing software and claim submission workflows. Audit all current claims using modifiers 26 and 27 to ensure compliance with the new policy effective date of 01/01/2025. Providers must understand when to append these modifiers to diagnostic codes, laboratory procedures, and imaging codes. Update billing templates and superbills to reflect correct modifier usage. Train billing staff on distinction between professional component (26) versus technical component (TC) billing. Failure to correctly apply modifiers will result in claim denials or improper reimbursement.