Radiology Billing Services in Texas
Texas's radiology practices face unique billing challenges shaped by Blue Cross Blue Shield of Texas's commercial rules, Texas Medicaid Managed Care requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both TX payer rules and radiology coding complexity.
Why Texas Radiology Practices Need Specialized Billing
Texas's healthcare market includes 65,000+ physicians, and radiology practices here face a payer market dominated by Blue Cross Blue Shield of Texas on the commercial side and Texas 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 TX 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 Texas's specific payer rules, authorization requirements, and 5 Texas 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 Houston to Arlington and across Texas.
Top CPT Codes for Radiology in Texas
Our TX coders handle these radiology codes daily, applying Novitas Solutions Medicare rules and Blue Cross Blue Shield of Texas commercial policies to each claim.
Texas Payer Challenges for Radiology
Every TX payer has specific rules for radiology claims. Here's how we navigate them.
Blue Cross Blue Shield of Texas Radiology Claims
Blue Cross Blue Shield of Texas processes the largest share of Texas commercial radiology claims. We know their TX 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.
Texas Medicaid Managed Care Radiology Billing
Texas Medicaid Managed Care routes radiology patients through 5 managed care plans: Superior HealthPlan, UHC, Molina, and 2 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 Texas with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around contrast rules to prevent medical necessity denials.
Denial Prevention for Texas Radiology
Common radiology denials in Texas 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 TX payer-specific documentation when denials occur.
Get Expert Radiology Billing in Texas
Free billing assessment for your TX radiology practice. See where revenue is leaking.
What We Handle for Texas Radiology Practices
Texas Radiology Billing Cost Comparison
Hiring an in-house biller with radiology expertise in Texas 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 TX 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 Texas and radiology billing resources.
Frequently Asked Questions
Fix Your Texas Radiology Billing
Call 888-701-6090 for a free billing assessment specific to your TX radiology practice. We'll show you where revenue is leaking and how to fix it.