Leak
No RBM prior auth on advanced imaging
The denial it triggers
Non-appealable denial
How we stop it
We secure the authorization up front
Radiology billing · Cambridge, MA
Radiology Billing Services in Cambridge, Massachusetts
Radiology billing services in Cambridge answer to a research-dense, teaching-hospital market where subspecialty reads, biotech-driven patient volume, and MassHealth managed care all collide on the same claim.
247 Medical Billing Services has billed imaging since 2005: we split each study into its professional and technical components, secure advanced-imaging authorizations before the scan, and route every claim to the correct Massachusetts payer — with a dedicated account manager, a free performance dashboard, HIPAA compliance, and SOC 2 Type II controls behind it.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Radiology for Cambridge practices
Diagnostic Imaging
CT & MRI
Ultrasound
Interventional
Mammography
And More
Radiology Billing Services in Cambridge for Every Practice
Cambridge is not Boston, and its imaging billing does not behave like a downtown hospital's. Around Kendall Square and the Harvard and MIT campuses, the demand runs through university health services, biotech-employee populations, and academic-affiliated outpatient centers — reads that are frequently subspecialty and frequently performed on facility-owned equipment, forcing a professional-technical split on nearly every study. A faculty radiologist interprets under the professional component (modifier 26) while the facility bills the technical component (TC); a freestanding center that owns both bills globally.
Massachusetts routing is its own discipline. MassHealth, the state Medicaid program, is increasingly delivered through Accountable Care Organizations and managed-care plans, each carrying its own prior-authorization and coverage rules, alongside traditional Medicare under its MAC, National Government Services (JK), whose Local Coverage Determinations govern medical necessity for advanced imaging. A Cambridge radiology claim clears only when it is pointed at the right ACO, MCO, or Medicare MAC and coded to that payer's edits — a combination a generalist billing company struggles to carry.
How radiology claims get paid
Codes appear only to show the mechanics our team runs on each Cambridge study.
| Study or element | How it's billed | What drives payment |
|---|---|---|
| MRI brain w/wo contrast (70553) | Prior auth, then 26 / TC or global | RBM authorization before the scan |
| Faculty read on hospital equipment (26) | Professional component, modifier 26 | Radiologist interprets; facility bills TC |
| CT abdomen/pelvis (74177) | Global, split by ownership | Who owns scanner vs read; site of service |
| PET imaging (78815) | Advanced imaging, LCD-governed | Medical necessity per NGS LCD |
| Contrast-enhanced study | Supervision documented | Contrast and supervision rules met |
| Subspecialty re-read / repeat | Modifiers 76 / 77 | Genuine re-read documented |
| Bilateral study | Modifiers RT / LT / 50 | Laterality documented |
Behind it: a 99% clean-claim rate, roughly 99% net collections, A/R under 25 days, up to 40% fewer denials, 90% denial recovery, and 24-hour submission.
Where Cambridge radiology practices lose revenue
Leak
Wrong or missing 26/TC split
The denial it triggers
Overpayment recoupment
How we stop it
We match the component to the site of service
Leak
LCD / medical-necessity mismatch
The denial it triggers
NGS edit denies the study
How we stop it
We match diagnosis to the covering LCD first
Leak
Wrong MassHealth ACO/MCO on file
The denial it triggers
"Not our member" rejection
How we stop it
We verify the active plan before every claim
Leak
NCCI bundling or duplicate reads
The denial it triggers
Component or second read rejected
How we stop it
We apply 59, 76 and 77 correctly
Your revenue review shows which of these is costing your Cambridge practice the most.
Revenue review
Put a dollar figure on what your radiology claims are leaving behind.
A certified radiology billing specialist reviews your coding, unit counts, authorizations and aged A/R against the payers you actually bill in Cambridge, MA — and puts a number on what your current process is leaving on the table.
- Professional and technical components billed to the right entity per site
- Advanced-imaging authorization confirmed before the study is read
- Contrast, laterality and comparison-study modifiers checked per payer
HIPAA & SOC 2
Back to you within one business day
No long-term lock-in
Request a Revenue Review
Tell us about your practice.
A radiology specialist will reach out within one business day.
Thanks — we’ve got it.
A radiology specialist will reach out within one business day.
Why Cambridge practices outsource radiology billing to 247MBS
Research-market, subspecialty-heavy practices are exactly where outsourcing to a professional, radiology-fluent team pays for itself. As a medical billing services company built around imaging, we clear the prior-auth queue, the 26/TC split, and the LCD and supervision checks before submission — not after a denial. We run eligibility and payer verification to pin the correct MassHealth ACO/MCO or Medicare MAC per patient, denial management and appeals worked to root cause, and A/R follow-up that chases aged imaging balances to resolution. Our compliant results — 99% clean-claim rate, roughly 99% net collections, A/R under 25 days, up to 40% fewer denials, 90% of denials recovered — are measured against your own book in the audit. It runs inside our radiology revenue cycle practice, one team and one dashboard, backed by 98% client retention.
Who we serve in Cambridge
We bill academic and subspecialty radiology groups, university- and hospital-affiliated outpatient radiology, freestanding imaging and diagnostic centers, teleradiology practices reading across state lines, and multi-specialty groups running in-office X-ray, ultrasound, and CT — across Cambridge, Somerville, Watertown, and the near-Boston corridor. Whether you own the equipment, only the read, or both, we bill the professional and technical pieces to match.
Medical Billing for Radiology in Cambridge
Subspecialty reads only pay reliably when medical billing for radiology in Cambridge is tuned to this research market, and that is what 247MBS delivers. We split the professional and technical components on the facility-owned equipment that dominates the Kendall Square, Harvard, and MIT footprint, clear advanced-imaging authorizations before the MRI, CT, or PET is performed, and point every claim at the correct MassHealth ACO or managed-care plan for a patient base heavy with university and biotech populations. Matching the diagnosis to the covering National Government Services determination up front is what keeps these high-value studies from denying. Practices see up to 40% fewer denials and roughly 99% net collections. Request a revenue review and we will show you where revenue slips.
Choosing a Radiology Billing Services Provider in Cambridge
Radiology billing across Massachusetts
Cambridge practices are billed out of the same Massachusetts desk. Statewide payer detail lives on the Massachusetts page.
Statewide
Massachusetts Radiology billing — the payer programs, authorities and rules behind every Cambridge claim.
Specialty hub
Radiology Billing Services Outsourcing — the codes, unit rules and denials nationally, without the local layer.
FAQ
Because the payer mix skews toward research and university populations and the ownership toward facility-based subspecialty reads. That means constant advanced-imaging authorization and a 26/TC split on most studies — we clear the authorization before the MRI, CT, or PET and bill the professional read under modifier 26 while the facility bills the technical component.
MassHealth through its ACOs and managed-care plans, Medicare and its MAC (NGS), and your commercial carriers. We confirm the active plan through eligibility before every claim.
Yes — we confirm the reading radiologist's multi-state licensure and enrollment and apply repeat-read modifiers 76 and 77 when a study is re-read.
26 / TC split·place of service·prior authorization·laterality
Ready to get more Cambridge claims paid on the first pass?
From solo practices to multi-provider groups, we bill Radiology for Cambridge practices with a dedicated account manager, certified coders and a live dashboard — so the units, authorizations and appeals that decide your month stop being the thing nobody has time for.
Prefer email? sales@247medicalbillingservices.com