1. NPM Knowledge Base
  2. Medical billing in dentistry

Modifiers TC and 26

Using modifiers TX and 26 in billing medical claims

These modifiers identify the “professional” and the “technical” components of services that combine both portions into one procedure code.

-TC is the technical component.

-26 is the professional component.

Medicare Part B Jurisdiction 8 (WPS) offers this additional information on appropriate and inappropriate use of these modifiers:

Appropriate Usage

• To bill for only the technical component of a test

• Procedures that have a "1" in the PC/TC field on the MPFSDB

• Procedures falling into the following types of service;

2 - Surgery

5 - Lab

8 - Assistant Surgeon

1 - Medical Care/Injections

4 - Radiology

6 - Radiation Therapy

• Used when billing both the professional and technical component of a procedure when the technical component was purchased from an outside entity. The provider would bill the professional on one line of service and the technical on a separate line.

Inappropriate Usage

• Do not submit the technical component separately when one physician performs both the professional and technical components on the same day.

• Appending it to:

• Professional component only procedure codes identified on the MPFSDB by a "2" in the PC/TC column

• Global test only procedure codes identified on the MPFSDB by a "4" in the PC/TC Column

• Technical component only procedure codes identified on the MPFSDB by a "3" in the PC/TC column

Additional Information

• Modifier 26 and TC are considered payment modifiers and must be reported in the first modifier field

• Code the procedure without modifiers when performing a global service. Do not report a procedure code with both modifiers 26 and TC

• The payment for the technical component portion of a test includes the practice expense and the malpractice expense

• Technical component procedures are institutional and cannot be billed separately by the physician when the patient is an inpatient, outpatient, or in a covered Part A stay in a skilled nursing facility (SNF) location.