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Update to the Reimbursement Policy for Professional Component of Radiology Services in Facility Places of Service

Effective November 1, 2019, consistent with nationally recognized code-editing guidelines, Healthfirst does not reimburse the professional component for radiology services anymore when billed by a radiation oncologist and a cardiologist in the inpatient or outpatient hospital setting. Only radiologists will be reimbursed for interpretations. 

Healthfirst also published information on modifiers that affect pricing. Below is the information on some of the most commonly used modifiers. For a full list, please click here.


October 2019