Radiology Billing Services in Delaware
Delaware's radiology practices face unique billing challenges shaped by Highmark Blue Cross Blue Shield's commercial rules, Delaware Medicaid requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both DE payer rules and radiology coding complexity.
Why Delaware Radiology Practices Need Specialized Billing
Delaware's healthcare market includes 3,000+ physicians, and radiology practices here face a payer market dominated by Highmark Blue Cross Blue Shield on the commercial side and Delaware Medicaid on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect radiology procedure coverage and medical necessity requirements. Generic billing teams without DE specific knowledge leave revenue on the table.
Radiology billing itself is complex. Radiology coding requires understanding of professional (mod 26) vs technical (mod TC) component billing, contrast administration rules (with/without/both), and the complex coding for interventional radiology procedures. When you combine this coding complexity with Delaware's specific payer rules, authorization requirements, and 2 Delaware Medicaid managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving radiology practices from Wilmington to Newark and across Delaware.
2026 Delaware Medicare Allowables for Radiology CPT Codes
These are the 2026 Medicare allowable amounts for radiology CPT codes in Delaware, processed under Novitas Solutions. Allowables are locality-adjusted, so DErates differ from other states — the highest-value radiology code below pays $297.29 non-facility here. Compare any code across states with our Medicare fee calculator by state.
Source: 2026 Medicare Physician Fee Schedule, DE locality (Novitas Solutions). Commercial Highmark Blue Cross Blue Shield rates typically run above these benchmarks; Delaware Medicaid rates run below. Figures for reference, not a guarantee of payment.
Delaware Payer Challenges for Radiology
Every DE payer has specific rules for radiology claims. Here's how we navigate them.
Highmark Blue Cross Blue Shield Radiology Claims
Highmark Blue Cross Blue Shield processes the largest share of Delaware commercial radiology claims. We know their DE specific fee schedules, prior authorization requirements for radiology procedures, and their appeal timelines when claims are denied. 26/TC splits must match the service your practice actually provides.
Delaware Medicaid Radiology Billing
Delaware Medicaid routes radiology patients through 2 managed care plans: Highmark Health Options, AmeriHealth Caritas. Each MCO has its own radiology authorization and billing rules that we manage.
Medicare (Novitas Solutions) Radiology Coverage
Novitas Solutions processes Medicare radiology claims in Delaware with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around contrast rules to prevent medical necessity denials.
Denial Prevention for Delaware Radiology
Common radiology denials in Delaware include 26/tc splits must match the service your practice actually provides and with contrast, without contrast, and with+without have different codes and rates. Our team catches these issues before submission and appeals aggressively with DE payer-specific documentation when denials occur.
Get Expert Radiology Billing in Delaware
Free billing assessment for your DE radiology practice. See where revenue is leaking.
What We Handle for Delaware Radiology Practices
Delaware Radiology Billing Cost Comparison
Hiring an in-house biller with radiology expertise in Delaware costs $38K-$52K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified radiology coders and DE payer specialists for a fraction of that cost.
$38K-$52K
In-House Biller Salary
+ benefits, software, space
2.49%
Go Medical Billing Rate
Full team, all services included
60-80%
Typical Cost Reduction
With better results
Related Pages
Explore our Delaware and radiology billing resources.
Frequently Asked Questions
Fix Your Delaware Radiology Billing
Call 888-701-6090 for a free billing assessment specific to your DE radiology practice. We'll show you where revenue is leaking and how to fix it.