Radiology Billing Services in Texas

Texas imaging runs at a scale no other state matches. Houston Methodist, MD Anderson, and Memorial Hermann anchor the Texas Medical Center; UT Southwestern and Baylor Scott & White dominate the Dallas–Fort Worth Metroplex; and University Health and community systems cover San Antonio, Austin, and El Paso. Around them sit hundreds of freestanding MRI and CT centers, mobile operators, and interventional groups reading under hospital contract. Every one of those claims turns on the same first decision: does the group interpret only, own the equipment, or both? Interpret only, and the read carries the professional component with modifier 26; own the scanner and the interpretation, and the study bills global. Get the component wrong in a provider-based department and the payer recoups after the fact.

For Medicare Part B, most of Texas sits under Novitas Solutions, Jurisdiction H, whose Local Coverage Determinations decide which diagnoses make an advanced study medically necessary. A read that skips the LCD match does not pay on the quality of the dictation alone. Our coders map the ordering diagnosis to the covering Novitas policy before the claim leaves the queue — the check a general billing company routinely skips.

Whether you run a hospital-based group reading for a Texas Medical Center department, a freestanding center in the Metroplex, an interventional practice in San Antonio, or a teleradiology group covering the Rio Grande Valley and West Texas, the billing has to match your footprint and the patient's plan. Teleradiology adds a licensure layer — a radiologist reading a Texas study from another state must be licensed and, where required, enrolled where the patient sits, and the claim must reflect the correct rendering location. We build the professional/technical split per site of service and route each claim to the correct STAR plan or TMHP, so the office that owns its scanner bills global, the group that only interprets bills the 26 component, and neither is over- or under-stated. One group, many plans, one accountable billing team.

Groups across the state outsource radiology billing because a general biller drowns in the number of Texas plans — and treats an imaging claim like an office visit. As a medical billing services company built specifically around imaging, we carry the per-plan RBM workflows, the Novitas LCD map, the PEMS discipline, and the component-split logic before your first claim goes out. Outsourcing here is not about cutting a check to a cheaper billing company; it is about handing the read to a team that already tracks every STAR plan's authorization rulebook. We run the full cycle:

All of it lives inside our radiology revenue cycle practice, and it complements the broader Texas medical billing services our team runs statewide — one billing services company, one dashboard, backed by a 98% client retention rate.

Start with a revenue review: we'll review your 26/TC splits, your per-plan advanced-imaging authorizations, your PEMS enrollment, your Novitas LCD matches, and your aging Texas Medicaid A/R, then show you what a focused imaging team can recover.