Modifier 26 is used by a physician who performs the professional component of a service, and Modifier TC is used when only the technical component of a service is performed. There are times when it is important to specify these separate services.
The professional component of a service is a physician’s supervision and interpretation of a service. For example, a physician preforms a procedure with a retrograde urography in a hospital. Along with the procedure code, the provider would bill 74420 with Modifier 26. The physician uses the urography machine as an aid to help perform the procedure, but since he does not own the machine, he only bills for the professional component.
The technical component of a service is the use of equipment at a hospital or other facility. Using the same example as above, the hospital would bill the 74420 with Modifier TC. Adding the TC indicates that the hospital owns the urography machine that the physician used in the procedure.
Of course, there are instances when neither of these modifiers is necessary. If a physician performs the retrograde urography in their office and the office owns the machine, then the 74420 would be billed without either modifier.
The best question to ask yourself when trying to decide whether to use one of these modifiers is, “Who owns the equipment?” The answer will determine which modifier should be used or if one should be used at all.