In the past when billing for the 91035, Bravo PH test, we have always billed with a -26 modifier. This indicates that we are billing for the professional component. (physician's interpretation) The hospital bills with a -TC modifier, which indicates that they are billing for the technical component. (owning the equipment) That way the insurance company knows they have to split the fee between the hospital and our physician.
So what we are wondering is - if we are providing the service, and own the equipment, are we correct in assuming we would bill the 91035 without modifiers? I believe that we would then get reimbursed 100% of the allowed amount.
We are also wondering, for those of you with ambulatory surgery centers and who own the Bravo equipment, how are you billing for the procedure? Did you have your ASC purchase the equipment and are you billing it as 91035 -26 for the physician, and 91035-TC for your ASC? Or did you have your medical office purchase the equipment and are you billing just the 91035 in the office setting?
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