MedCare MSO provides radiology billing and coding services for imaging centers, IDTFs, hospital radiology departments, and teleradiology groups. Certified coders handle TC and PC split billing, contrast capture, prior authorization, and payer compliance across every modality, with AI checking each claim before it leaves and a coder signing off before it reaches a payer.
Book A Free ConsultationPartner with us for streamlined radiology billing services, so you can focus on patient care with ease.
Submitting a claim is straightforward. What separates a radiology billing partner is knowing which entity bills which component of a CT scan, catching the contrast code that slips off the claim, and fixing the place of service mismatch that denies your remote reads.
Who owns the equipment and who employs the radiologist decides whether a claim carries modifier TC, modifier 26, or bills globally. Getting the split wrong is the most expensive recurring error in radiology billing. We assign the component structure from the facility arrangement on file, so nothing bills twice or not at all.
Contrast agents bill separately from the imaging CPT code using HCPCS Q-codes, with agent type, route, volume, and NDC documented on every contrast-enhanced study. Non-specialist teams routinely leave this revenue off the claim. Our scrubbing flags any study missing its contrast charge.
The same study reimburses differently in an office, hospital outpatient department, IDTF, or mobile unit, and the wrong POS code triggers automatic payment reductions or denials. We code Place of Service to match the setting and align it with the TC/PC structure.
Bilateral studies need modifier 50 or LT/RT applied correctly, and some codes already include bilateral imaging while others require separate reporting. Same-session studies must then clear NCCI edit pairs, which takes precise sequencing of modifiers 59, 76, 77, XS, and XU, each with supporting documentation.
We will audit a sample of your recent imaging claims and show you where component splits, contrast charges, and modifier sequencing leak revenue.
Get a Free Billing AuditOur radiology billing and coding services cover the full 70010 to 79999 diagnostic series, with code selection validated against body region, view count, contrast status, and whether the study is limited or complete.
X-ray, CT, MRI, ultrasound, and fluoroscopy coded to protocol. Contrast status drives code selection: CT head without contrast (70450), with (70460), with and without (70470), and view counts must match the report: chest X-ray one view (71045) versus two (71046).
Supervision and interpretation billing for vascular and non-vascular procedures, angiography, embolization, biopsy, drainage, including guidance codes 76942 (ultrasound), 77012 (CT), and 77021 (MRI), coordinated with facility billing so the professional fee is captured without duplication. Add-on codes such as 76937 and 3D rendering (76376, 76377) are captured where documentation supports them.
Bone scans coded by extent of study across 78300 to 78315, myocardial perfusion SPECT across 78451 to 78454, and whole-body PET (78816) billed with the ordering diagnosis aligned to coverage criteria. Prior authorization is managed before the date of service, not after a denial.
Screening versus diagnostic selection is determined by the clinical indication on the order, not by convention, and it is one of the few radiology RCM decisions that affects patient cost-sharing as much as reimbursement. Our radiology billing and coding services select screening mammography (77067) and diagnostic studies (77065 unilateral, 77066 bilateral) from the documented indication.
Teleradiology needs radiology billing and coding services that follow the study across state lines. Remote reads are billed under correctly licensed and credentialed provider NPIs, with multi-state licensure tracking and payer enrollment managed for every state where studies originate. That closes the exposure of billing interpretations under providers not enrolled with the patient's payer.
Neuroradiology and musculoskeletal work, brain and spine MRI, CT angiography, joint imaging, DEXA, coded to subspecialty conventions by radiology billing and coding services staff who work these studies daily, with NCCI edits checked when multiple regions are imaged.
| CPT / HCPCS | Service | Most Common Denial Driver & How We Prevent It |
|---|---|---|
| 70450 / 70460 / 70470 | CT head without, with, with and without contrast | Code does not match contrast status in the report; prior authorization missing. We select the code from the documented contrast status and verify PA against the date of service. |
| 70551 to 70553 | MRI brain | Contrast documentation absent; payer PA expired before date of service. Our team tracks authorization expiry against rescheduled scans, not just the original order. |
| 71045 / 71046 | Chest X-ray, 1 or 2 views | View count billed exceeds views documented in the radiology report. Our time reconcile the billed view count to the report before submission. |
| 77065 to 77067 | Mammography, diagnostic and screening | Screening code billed for a diagnostic indication, or the reverse. We select from the clinical indication on the order rather than by convention. |
| 76942 / 77012 / 77021 | US / CT / MRI guidance for interventional procedures | Billed globally when only the professional component (modifier 26) applies. We assign the component split from the facility arrangement on file. |
| 76376 / 76377 | 3D rendering add-on codes | Omitted entirely, or billed without independent workstation documentation for 76377. We capture the add-on where the report supports it and check for the workstation note. |
| 78300 to 78315 | Bone scan, limited to three-phase | Extent of study billed not supported by documentation. We match the extent billed to the phases actually documented. |
| 78451 to 78454 | Myocardial perfusion imaging (SPECT) | Prior authorization missing; stress study components incorrectly bundled. We secure PA before the study and run stress components against current NCCI edits. |
| 78816 | PET, whole body | Ordering diagnosis does not meet coverage criteria; commercial PA absent. We check the ordering diagnosis against payer coverage policy before the claim is built. |
| Q-codes (Q9951 to Q9967) | Contrast agents | Not billed separately from the imaging code; agent, volume, or NDC undocumented. Our scrubbing flags any contrast-enhanced study missing its Q-code charge. |
Correct ordering-diagnosis coding is where our radiology medical billing services prevent the regular driver of imaging denials. Missing or incorrect ordering diagnoses are among the most common reasons radiology claims are denied. Our coders align the referring diagnosis to payer medical necessity policy, Medicare Local Coverage Determinations (LCD), National Coverage Determinations (NCD), and commercial equivalents, before the claim goes out, including screening encounters (Z12.x), solitary pulmonary nodule follow-up (R91.1), and abnormal imaging findings (R93.x). Where an order carries only a rule-out diagnosis, we code to the documented signs and symptoms instead.
Partner with expert radiology billing services to improve coding accuracy and accelerate reimbursements.
Talk to a Billing ExpertTwo places imaging claims stop before payment: an edit never cleared, and an authorization never secured.
Our radiology billing and coding services check every claim against four Medicare compliance systems before it goes out. Radiology reimbursement runs on all four. Same-session studies clear current NCCI edit tables before submission, so separately reportable procedures carry the right modifier and bundled services are never billed apart. Units billed per code per day are validated against MUE limits, catching duplicate charges before a payer stops the claim. MPPR is where imaging revenue quietly leaks: we sequence claims so the highest-value study prices first, then audit remittances against your contracted fee schedule to catch overreductions. CMS has paused mandatory AUC, but many payers still require clinical decision support for advanced imaging, so we track requirements payer by payer.
Authorization denials are avoidable, and we treat them that way. Our radiology medical billing services manage the full PA lifecycle for CT, MRI, PET, and nuclear medicine across Medicare, Medicaid, and commercial plans: submission with clinical documentation, payer follow-up before the procedure date, expiration tracking against the date of service, and appeals with clinical support attached when a payer still denies the study. Studies are pre-approved before scheduling, so patient care is not delayed and revenue is not lost to an authorization that has lapsed on a rescheduled scan. Where a payer requires a peer-to-peer review, we coordinate it directly with your radiologist rather than letting the request quietly expire.
Recovering denied imaging revenue is core to our radiology billing services. Our denial management resolves the root cause, so the same denial does not come back next month.
Insufficient clinical justification for advanced imaging. We strengthen documentation of history, indications, and diagnosis codes before submission, and appeal with clinical support when denials occur.
Missing or expired authorization for CT, MRI, and PET. Prevented through the PA workflows above, and appealed with the payer's own approval record when the authorization existed but the claim was denied anyway.
Incorrect TC, PC, or global splits and missing modifiers (26, TC, 59, LT/RT), caught through coder review and automated scrubbing.
Procedures billed together that payers consider inclusive are reviewed against current edit tables before claims go out, and eligibility issues are caught at verification.
Identify
Every claim is tracked through its lifecycle, so none ages silently in A/R. Radiology RCM only works when nothing falls out of view.
Categorize
Each denial is tagged by payer and reason: necessity, authorization, modifier, or timely filing.
Correct
The root cause is fixed at the source: coding, documentation, or eligibility.
Appeal
Denied claims are appealed with clinical documentation and coding rationale.
Recover
Recovered cash is posted and reconciled, and the pattern is closed. Balances aged past 90 days go to our A/R recovery team.
Hand us the backlog. When you outsource radiology billing to us, we work the root cause, file appeals, and pursue aged balances your team has had to let go.
See Denial Management
Radiology RCM requirements change with the setting. Our radiology billing services adapt to each setting, because a radiology billing company that treats an ambulatory imaging center the same as a hospital outpatient department (HOPD) will misbill both.
Add a single AI product that fixes your biggest bottleneck, or integrate the complete AI Ecosystem into your radiology revenue cycle. Every agent runs with a human in the loop (HITL), so nothing reaches a payer without a certified coder's review.
HealUS syncs radiology clinical records, including PACS and RIS data, with billing and coding in real time. We also integrate with Epic Radiant, Cerner, and GE Centricity if you keep your current system, with HL7 and FHIR interoperability and live analytics.
Salus captures clinical documentation as structured data feeding directly into coding and billing, with the clinician signing every note.
Sophus assigns radiology CPT, ICD-10, and HCPCS codes with the correct modifiers, validated against protocol, body region, contrast status, and laterality, then routed to a certified coder.
Maximus handles scheduling, charge entry, claim submission, and status tracking for radiology practices and imaging centers, with live dashboards on denials and A/R aging.
Book a walkthrough with your MedCare MSO representative and see the chart, the portal, and integrated billing working as one.
Most billing companies send a monthly report and go quiet. You get live access to the same dashboards our billers use, and a named account manager who knows your modality mix. That is the difference between a general biller and a radiology billing company that knows your modality mix. Practices that outsource radiology billing to MedCare MSO get specialty-trained staff backed by the infrastructure we bring to 50+ specialties:
Practices that outsource radiology billing this way stop losing revenue to component errors they could not see.
Explore Our AI-Powered RCMFlat collections across three quarters despite growing volume, with denials in the low twenties and no root-cause visibility. High denial rates, administrative inefficiencies, and delayed revenue recovery due to complex billing workflow challenges.
to 7%, clean claim rate to 96%, days in A/R from 54 to 33, and contrast charge capture from roughly 60% to 98%, through corrected component splits and pre-submission edits.
| Metric | Before | After | Improvement |
|---|---|---|---|
| Denial Rate | 22% | 7% | Significant Drop |
| Clean Claim Rate | 81% | 96% | +15% Increase |
| Days in A/R | 54 | 33 | Faster Cash Flow |
| Contrast Capture | ~60% | ~98% | Revenue Recovered |
I highly recommend MedCare MSO if you are looking for help with your billing and gain some freedom to see more patients or manage your business.
Practice Owner, TXEC
MedCare MSO has been an excellent organization to work with, I highly recommend them for their quality of service and commitment to excellence.
Back Office Manager, STST
We are definitely impressed by the Team’s performance. I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Director of Corporate Development, SC & SF
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Owner, R.D.
MedCare MSO did a great job with our billing and helping clean up old AR. Regular updates and good communication were very appreciated.
Co-Owner, PCP
Chief Operating Officer, MAKO MEDICAL LABORATORIES
Chief Executive Officer, CARE NOW CLINIC
Chief Operations Officer, ION DIAGNOSTICS
Co-Founder, AW Care
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
Practice Owner, F&A Clinic
We have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage.
President/CEO, RLT
I am impressed with MedCare MSO’s promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases.
Practice Owner/FBH
Contrast agents are billed separately from the imaging CPT code using the correct HCPCS Q-codes, with agent type, route, volume, and NDC documented. Claim scrubbing flags any study where the contrast charge is missing, so this routinely omitted revenue stays on your claims.
Place of Service is one of the first things our radiology medical billing services verify, because it determines both the reimbursement rate and which components you can bill. We apply the correct POS for office, hospital outpatient, IDTF, and mobile settings, and align the TC, PC, or global structure to equipment ownership and the radiologist's employment arrangement.
AUC is the clinical decision support standard for advanced imaging orders. CMS has paused its mandatory AUC program, but many commercial payers still require CDS documentation for CT, MRI, and PET. We track those requirements payer by payer, so AUC-related denials do not reach your A/R.
Every same-session claim is checked against current NCCI edit tables and MUE unit limits before submission. Where studies are separately reportable, our radiology medical billing services apply the correct modifier sequencing (modifier 59, 76, 77, XS, XU) with documentation to support each one. Unbundling and upcoding are the two findings that turn a routine payer review into a RAC audit, and we code to avoid both.
The technical component (modifier TC), professional component (modifier 26), and global billing are assigned based on your equipment ownership and radiologist arrangement, so every claim is reimbursed to the right party.
Yes. We integrate with your existing radiology EHR/EMR and practice management systems, including PACS and RIS platforms such as Epic Radiant, Cerner, and GE Centricity. If you would rather upgrade, HealUS EHR, Salus AI Scribe, and Sophus AI Coder are available. Most practices go live within 14 days.
We work only imaging claims across every modality and setting, from IDTFs to hospital-based groups and teleradiology, so component splits, contrast capture, and NCCI sequencing are handled by coders who see these studies every day.
TXEC
I have worked with MedCare MSO for the past eight months, and it has been a great experience. Moses, Mark, Travis, Sebastian, and Tammy have been a pleasure to work with, as well as the rest of the team, including the credentialing folks.
I highly recommend this group and MedCare MSO if you are looking for help with your billing. They will meet with you once a week to review the issues that need to be fixed to improve your payment and capture rate.
If you are looking for help with your billing and gain some freedom to see more patients or manage your business, this is the team you need to work with.
Dr. Jose Correa
Practice Owner
TXEC
STST
MedCare MSO has been an excellent organization to work with. Mark has consistently demonstrated outstanding attention to detail, thorough documentation, and strong professionalism in maintaining accurate records of his findings.
His reliability and dedication have contributed greatly to a positive experience.
I highly recommend MedCare MSO for their quality of service and commitment to excellence. I can’t say enough good things about Mark and his company.
Thank you
Shaunna Mock
Back Office Manager
STST
SC & SF
Hi Ali, I hope this message finds you well. I wanted to give you some feedback on the team.
We are definitely impressed by the Team’s performance. Definitely what we were looking for from switching partners.
In particular Mark Zaiden has been very helpful. In my 5+ years of experience as a M&A Professional, I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Austin has done a great job of leading the communications process and keeping the train going in the right direction. Tammy and some other folks have been key players as well. We really are happy with everyone on the team.
I wanted to pass this feedback along to you as we are really pleased with working with MedCare MSO so far.
Have a great weekend!
Max Owens
Director of Corporate Development
SC & SF
R.D.
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Most helpful is the open/responsive communication of their team with my office and each other, along with the specialty levels of expertise amongst my team for each aspect of RCM.
Kelly Ballou
Owner
R.D.
F&A Clinic
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
I would like to take time to recognize two members of MedCare MSO specifically. Moses for his exceptional support and dedication. He is always responsive, and knowledgeable, and goes above and beyond to ensure smooth operations. His professionalism and commitment make a huge difference in our day-to-day workflow. George also for his quick feedback and recognition of what is needed most. He is extremely efficient and always available for clarification and to share his knowledge and expertise.
I highly recommend MedCare MSO to any healthcare provider looking for a reliable and efficient billing partner.
RLT
Hello,
I am writing this email to express our appreciation of the MedCare MSO’s team and all they have done for our business at RLT. In the past year, we have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage. We went from having over $100k in uncollected/billed claims to now reaching near $100k in collection some months.
We are also happy to express our thankfulness that MedCare MSO is now helping us acquire new contracts with different insurance companies. This will in effect benefit everyone involved, allowing us to expand our services and provide more resources for our staff/business partners.
Please note special appreciation for the following:
David Lucas
Mario Ortega
Ambrose William
FBH
I have been a customer of MedCare MSO for one year. They have provided billing and credentialing services for my private behavioral health practice, and I am impressed with their promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases, and with their willingness to educate me and my staff about the ever-changing rules of medical billing and the best use of coding. This is a company I Trust with my billing needs.
Dr. Neufeld
Practice Owner
FBH
