Modifier 26: Professional component
When it is appropriate
Append modifier 26 when billing only the professional, interpretive component of a test or procedure that has both a professional and a technical component, such as reading and reporting on an imaging study performed using equipment the billing provider does not own.
When it is not appropriate
Do not use 26 when the same provider owns the equipment and performed the entire service, since then the global unmodified code is correct, and do not use it expecting it to bypass a bundling edit, since it does not do that.
CMS preference
26 selects which component of a split code is being billed; it is not one of the modifiers CMS lists as able to bypass an NCCI PTP edit.
Retrieved 2026-07-18.
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DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.