Radiology billing is a complex process, especially when differentiating between the ordering physician and the rendering physician. Confusion around these roles can lead to billing errors, compliance risks, and delayed reimbursements.In this updated 2025 guide, Med Billing RES breaks down the differences between these two key roles, highlights new CPT code changes, and provides best practices to streamline radiology billing 2025 workflows and get paid faster.
Understanding the Roles: Ordering vs. Rendering Physician
Ordering Physician
- Requests Imaging Services: The ordering physician (often a primary care provider or specialist) determines the need for diagnostic imaging, such as MRIs, CT scans, or X-rays, and submits the order.
- Does Not Perform Procedures: Their role is limited to assessing clinical need and referring patients to imaging centers or radiologists.
Rendering Physician
- Performs and Oversees the Service: The rendering physician, typically a radiologist, supervises or performs the imaging and ensures accurate execution.
- Provides Interpretation: They review images and issue a detailed diagnostic report that supports treatment planning.
Key Takeaway: Correctly documenting these roles is essential for compliant billing and clean claim submission.
Technical vs. Professional Components in Radiology Billing
Radiology billing typically separates technical (TC) and professional (PC) services.
| Component | What It Covers | Billed By |
| Technical (TC) | Imaging equipment, staff, and facility usage | Imaging facility or hospital |
| Professional (PC) | Radiologist’s review, interpretation, and reporting | Rendering physician or radiology practice |
Modifiers to Remember:
- -TC: Technical component only
- -26: Professional component only
Correct use of these modifiers helps avoid claim denials and ensures both entities are reimbursed properly.
New CPT Code Updates for Radiology (2025)
The American College of Radiology Billing (ACR) has introduced new Category I CPT codes and retired outdated ones. Below are some highlights:
| Category | New/Updated Code | Description |
| MR Safety Procedures | 7XX00-7XX05 | MR safety assessments, implant prep, and customization with written reports |
| MRI-Monitored TULSA | 5X006-5X008 | MRI-guided prostate tissue ablation procedures |
| MRgFUS | 0398T | Converted to Category I; includes planning, insertion, and ablation |
| Transcranial Doppler Studies | 93893 | Revised emboli detection code with updated reporting requirements |
| Fascial Plane Blocks | 64486-64489 | Updated TAP block codes for bilateral and unilateral injections and infusions |
| Thyroid Ablation | New Code | CPT added for percutaneous RF ablation with add-ons for additional nodules |
| CT Colonography | – | Officially added to Medicare screening coverage for colorectal cancer |
Common Challenges in Radiology Billing
1. Incorrect Coding: Upcoding & Undercoding
Both errors affect compliance and revenue:
- Undercoding: Billing for a less complex procedure than performed (leads to underpayment).
- Upcoding: Billing for a more complex procedure than performed (can trigger audits or penalties).
Solution: Regular coding audits, staff training, and automated claim scrubbing.
2. Incomplete Documentation
Missing or unclear medical necessity documentation from the ordering physician often leads to denials. Radiology reports must align with billed CPT codes.
Solution: Standardize reporting templates and integrate EMR prompts for required details.
3. Payer-Specific Rules
Commercial and government payers frequently update authorization, bundling, and reimbursement policies.
Solution: Assign a payer liaison to monitor policy changes and update internal workflows.
Best Practices for Accurate Radiology Billing
✅ Enhance Communication: Keep ordering and rendering providers aligned to avoid claim rejections.
✅ Quarterly Audits: Detect coding inconsistencies early and train staff accordingly.
✅ Stay Updated on Regulations: Regularly review ACR, CMS, and payer guidelines.
✅ Use RCM Software: Automate claim scrubbing, code validation, and denial tracking.
✅ Partner with Specialists: Med Billing RES offers radiology-specific billing expertise, helping practices reduce A/R days by 30%.
Why Choose Med Billing RES for Radiology Billing?
- Specialty-Focused Team: AAPC-certified radiology coders and billing experts
- AI-Driven Automation: Faster claim submission and real-time error detection
- 98%+ Clean Claim Rate: Proven track record of reducing denials
- Compliance-First Approach: Stay ahead of coding changes and audits
With Med Billing RES, Radiology billing 2025 practices can focus on patient care while we handle billing accuracy, compliance, and faster reimbursements.
Final Thoughts
Radiology billing 2025 is evolving rapidly, with new CPT codes, payer policies, and compliance requirements. Practices that invest in accurate documentation, coding audits, and automation will stay ahead of reimbursement challenges.Whether you manage billing in-house or outsource to Med Billing RES, a proactive billing strategy ensures your practice remains profitable, compliant, and audit-ready.
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