Medicare AdvantageBilling CodesHigh impact
MA03.011o, Modifiers 26 (Professional Component) and TC (Technical Component)
Independence Blue Cross·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Policy MA03.011o clarifies the use of modifiers 26 (Professional Component) and TC (Technical Component) for Medicare Advantage plans, effective January 1, 2025. This policy governs how diagnostic and therapeutic procedures should be billed when separating professional services from technical/facility components. Billing teams must ensure all applicable procedures use correct modifier combinations to avoid claim denials.
Action Required
By March 15, 2025: Billing team must review all diagnostic and procedural codes in the practice's billing system to identify which procedures require modifiers 26 and TC per policy MA03.011o. Update billing software templates and encounter forms to automatically append correct modifiers when professional and technical components are billed separately. Providers must document whether services include both professional and technical components or are being split. Retrain billing staff on proper modifier application for Medicare Advantage claims. Failure to apply correct modifiers will result in claim denials or downcoding by Medicare Advantage plans.