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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2016

Reminder: Billing for Professional, Technical, and Global Services

Harvard Pilgrim would like to offer providers a reminder on billing for professional services, technical services, and global services. When billing for a global service, meaning that you provided both the professional and technical components of the service, please submit the service on one line, and do not append any modifier to the claim. No modifiers are necessary to receive payment for both components of the service; submitting modifier 26 and modifier TC on the same claim line may result in a denial or a delay of payment.

In the event that you have provided professional services only for a procedure that includes both professional and technical elements, submit the claim for the appropriate CPT code with modifier 26. If you have provided the technical component of a service only, indicate this by appending modifier TC when you bill for the service. For further details, reference the CPT and HCPCS Level II Modifiers Payment Policy in Harvard Pilgrim’s online Provider Manual.

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    Eric H. Schultz,
    President and Chief Executive Officer

    Robert Farias,
    Vice President, Network Services

    Annmarie Dadoly,

    Joseph O'Riordan,

    Kristin Edmonston,
    Production Coordinator