Radiology Billing Services in New York
New York's radiology practices face unique billing challenges shaped by Empire BlueCross BlueShield's commercial rules, NY Medicaid Managed Care requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both NY payer rules and radiology coding complexity.
Why New York Radiology Practices Need Specialized Billing
New York's healthcare market includes 90,000+ physicians, and radiology practices here face a payer market dominated by Empire BlueCross BlueShield on the commercial side and NY Medicaid Managed Care 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 NY 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 New York's specific payer rules, authorization requirements, and 6 NY Medicaid Managed Care 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 New York City to Albany and across New York.
Top CPT Codes for Radiology in New York
Our NY coders handle these radiology codes daily, applying Novitas Solutions Medicare rules and Empire BlueCross BlueShield commercial policies to each claim.
New York Payer Challenges for Radiology
Every NY payer has specific rules for radiology claims. Here's how we navigate them.
Empire BlueCross BlueShield Radiology Claims
Empire BlueCross BlueShield processes the largest share of New York commercial radiology claims. We know their NY 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.
NY Medicaid Managed Care Radiology Billing
NY Medicaid Managed Care routes radiology patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, and 3 more. 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 New York with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around contrast rules to prevent medical necessity denials.
Denial Prevention for New York Radiology
Common radiology denials in New York 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 NY payer-specific documentation when denials occur.
Get Expert Radiology Billing in New York
Free billing assessment for your NY radiology practice. See where revenue is leaking.
What We Handle for New York Radiology Practices
New York Radiology Billing Cost Comparison
Hiring an in-house biller with radiology expertise in New York costs $45K-$62K 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 NY payer specialists for a fraction of that cost.
$45K-$62K
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 New York and radiology billing resources.
Frequently Asked Questions
Fix Your New York Radiology Billing
Call 888-701-6090 for a free billing assessment specific to your NY radiology practice. We'll show you where revenue is leaking and how to fix it.