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Modifier 26

Modifier 26 Description and Billing Use

Plain-language description

Identifies the professional component when professional and technical components may be billed separately.

How modifier 26 is used

Modifier 26 identifies the professional component when a service has separately reportable professional and technical components. Confirm that the code permits component billing and that the reporting professional performed and documented the interpretation or other professional work.

Before reporting this modifier

  1. 1. Confirm the current official or licensed definition and payer acceptance.
  2. 2. Identify the exact claim circumstance the modifier communicates.
  3. 3. Make the code, setting, related services, and medical record consistent.
  4. 4. Check NCCI, global surgery, component, DME, ABN, or drug rules that apply.
  5. 5. Do not append a modifier only to force an edit override.
LessonStudy the related billing ruleOfficial sourceReview current CMS guidance

This is a workflow summary, not a licensed CPT definition or claim-specific coding instruction. Verify the code set and payer rule effective for the date of service.