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Simply Healthcare Plans, Inc.
Clear Health Alliance
Medicaid Managed CareReimbursement Policy
Subject: Modifier 26 and TC: Professional and Technical Component
Effective Date:
07/01/17Committee Approval
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What is subject modifier 26 and?
Subject modifier 26 is a code used to indicate that professional services have been provided as part of a medical billing claim.
Who is required to file subject modifier 26 and?
Health care providers such as physicians, surgeons, and other medical professionals who provide professional services as part of a medical billing claim.
How to fill out subject modifier 26 and?
Subject modifier 26 is typically filled out on the CMS-1500 claim form in the designated modifier field.
What is the purpose of subject modifier 26 and?
The purpose of subject modifier 26 is to differentiate between professional services provided by a health care provider and other services or charges on a medical billing claim.
What information must be reported on subject modifier 26 and?
Subject modifier 26 must include the code indicating professional services, along with any other relevant information specified by the health insurance provider.
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