Discontinued Split Billing for Select Lab Codes

Effective for dates of service on or after July 1, 2014, certain pathology related CPT codes will no longer be split billable using modifiers 26, TC or ZS. The change in billing status is the result of Medi-Cal aligning split-bill percentages with CMS split-bill percentages. These codes are not separately reimbursable to different providers for a professional or technical component. Only one provider may bill for these codes. These codes must not be submitted with modifier 26, TC or ZS.

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INDUSTRY NEWS TAGS: California Medi Cal

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