Modifier 26; Professional
Modifier TC; Technical Component
26; Professional Component; Modifier TC;
Originally Created: 02/01/2009
||Policy No: 106
|Last Reviewed: 06/01/2014
||Last Revised: 06/01/2014
||Effective Date: 07/01/2014
This policy applies to all physicians, other qualified health care professionals, hospitals and other facilities.
Current Procedural Terminology (CPT®) modifier 26 represents the professional (provider)
component of a global service or procedure and includes the
provider work, associated overhead and professional
liability insurance costs. This modifier corresponds
to the human involvement in a given service or procedure.
HCPCS Level II modifier TC
HCPCS Level II modifier TC represents the technical component of a global service or
procedure and includes the cost of equipment and supplies to perform that service
or procedure. This modifier corresponds to the equipment/facility part of a given
service or procedure.
A global service
A global service represents a complete service
or procedure that includes both the professional and
The Centers for Medicare & Medicaid Services (CMS)
designate which procedure codes are valid for use with modifier 26 and modifier TC. Our health plan utilizes these
CMS designations in determining procedure code/modifier
combinations that are valid for our use. Procedure
code/modifier combinations that are considered not
valid for our health plans use will be denied.
Correct coding guidelines require that modifier 26
be used when the professional component of a global
service is the only service provided (i.e. supervision
and/or interpretation codes.)
Correct coding guidelines require that modifier TC
be used when the service provided represents only the
equipment or facility component of a global service
and not the professional component of the same service.
Hospitals frequently provide only the technical component
of some services. Hospitals are not currently required
to submit the TC modifier, but will be reimbursed
as if the TC had been billed.
A global procedure code should be reported when
a single provider or entity performs both the professional
and technical components of a given service.
Centers for Medicare & Medicaid Services (CMS), National Physician Fee Schedule Relative Value File
American Medical Association. "Appendix A: Modifiers" Current
Procedural Terminology (CPT). AMA Press
Centers for Medicare & Medicaid Services (CMS). "Appendix A: Modifiers". Health
Care Procedure Coding System (HCPCS). Ingenix
Your use of this Reimbursement Policy constitutes your agreement to be bound
by and comply with the terms and conditions of the Reimbursement
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