CPT Code 76705 is a medical billing code used for a specific type of ultrasound test. This code appears on bills when a doctor orders an ultrasound to look at your abdomen. Medical practices, hospitals, and imaging centers use this code every day to bill insurance companies for this common diagnostic test.
Understanding this code helps medical billing staff submit correct claims and helps patients know what they’re being charged for when they receive abdominal imaging services. This guide explains everything you need to know about CPT Code 76705, from what it covers to how to bill it properly.
What CPT Code 76705 Means?
CPT Code 76705 describes an ultrasound examination of the abdomen. The full description is “ultrasound, abdominal, real time with image documentation, limited.” The word “limited” means the ultrasound looks at specific organs or areas rather than scanning the entire abdomen.
This is a diagnostic imaging code. Doctors order this test when they need to see inside your abdomen to check for problems or monitor existing conditions. The ultrasound uses sound waves to create pictures of organs like the liver, gallbladder, kidneys, or spleen.
The test is non-invasive, which means no surgery or needles are involved. A technician applies gel to your skin and moves a device called a transducer across your abdomen. The transducer sends sound waves into your body and receives echoes that create images on a screen.
Difference Between 76705 and Other Abdominal Ultrasound Codes
The CPT system includes several codes for abdominal ultrasounds. Each code covers different levels of examination. Understanding these differences prevents billing errors and claim denials.
| CPT Code | Description | What It Covers |
| 76700 | Complete abdominal ultrasound | Full scan of entire abdomen |
| 76705 | Limited abdominal ultrasound | Specific organs or areas only |
| 76706 | Follow-up ultrasound | Checking previously identified issue |
CPT Code 76700 is for a complete abdominal ultrasound. This means the technician examines all the major organs and structures in your abdomen. The radiologist reviews images of your liver, gallbladder, common bile duct, pancreas, spleen, kidneys, and the major blood vessels in your abdomen.
Code 76705 is for a limited exam. The doctor orders this when they only need to check one or two specific organs. For example, if you have right upper belly pain, the doctor might order a limited ultrasound to look at just your gallbladder for stones.
Code 76706 covers follow-up exams. If an earlier ultrasound found something that needs monitoring, like a kidney stone or liver cyst, this code bills the repeat imaging done to check if the condition has changed.
Using the wrong code causes problems. If you perform a complete exam but bill 76705, you’re undercharging for your service. If you bill 76700 but only examined the gallbladder, you’re overbilling and could face audits or fraud allegations.
When to Use CPT Code 76705
Doctors order limited abdominal ultrasounds for many reasons. Knowing the appropriate situations helps billing staff code correctly and helps practices avoid unnecessary denials.
Common Medical Reasons
Right upper belly pain often prompts a limited ultrasound focused on the gallbladder. Gallstones are very common and an ultrasound is the best way to see them. The exam looks at the gallbladder size, wall thickness, and whether stones are present.
Kidney problems may require a limited exam of just the kidneys. Doctors check for kidney stones, blockages, or abnormal kidney size. Patients with known kidney disease often get repeat limited ultrasounds to monitor their condition over time.
Liver issues sometimes need targeted imaging. If blood tests show abnormal liver function, a limited ultrasound can check for fatty liver, cirrhosis, or masses. The exam measures liver size and looks at its texture and appearance.
| Medical Condition | Area Examined | What Doctor Looks For |
| Gallstones | Gallbladder | Stones, inflammation, wall thickening |
| Kidney stones | Kidneys | Stones, blockage, swelling |
| Liver disease | Liver | Size, texture, masses, fluid |
| Spleen enlargement | Spleen | Size and appearance |
Abdominal pain without a clear cause might get a limited exam first. If the doctor suspects a specific organ based on where the pain is located, they may start with a targeted ultrasound rather than ordering a complete exam immediately.
Screening vs Diagnostic Use
Most uses of 76705 are diagnostic, meaning the patient has symptoms or abnormal test results that need investigation. Insurance companies usually cover diagnostic ultrasounds without problems when medical necessity is documented.
Screening ultrasounds happen when someone has no symptoms but wants to check for hidden problems. Insurance coverage for screening varies greatly. Many plans don’t cover screening abdominal ultrasounds unless you have specific risk factors.
Documentation Requirements for 76705
Proper documentation protects your practice during audits and proves you provided the service you billed. Insurance companies can request records months or years after the exam was performed.
What the Order Must Include
Every ultrasound needs a written order from a physician or other qualified provider. The order should specify what area needs imaging and provide the medical reason for the test.
A proper order includes the patient’s name and date of birth, the type of exam requested, and the clinical indication. Generic orders like “abdominal ultrasound” without specifics make it harder to determine if 76705 or 76700 is the appropriate code.
The ordering provider must be someone authorized to order diagnostic tests. This usually means physicians, nurse practitioners, and physician assistants. In some states, other providers like chiropractors or naturopaths can order imaging, but insurance coverage may differ.
Technical Documentation
The ultrasound technician creates a technical report documenting what they examined and what images they captured. This report should clearly state which organs or structures were scanned.
For 76705, the technical documentation must show a limited exam. If the report lists images of the liver, gallbladder, pancreas, spleen, kidneys, and aorta, that’s a complete exam and should be billed as 76700, not 76705.
Image documentation is required. The technician must save representative images from the exam. These images prove the test was performed and provide the visual information the radiologist interprets.
| Documentation Element | Required Information |
| Patient identification | Name, date of birth, medical record number |
| Exam date and time | When the ultrasound was performed |
| Ordering provider | Doctor who requested the test |
| Clinical indication | Medical reason for the exam |
| Organs examined | Specific structures scanned |
| Images saved | Visual documentation of findings |
Interpretation Report
A physician, usually a radiologist, reviews the images and writes an interpretation report. This report describes what the ultrasound shows and provides diagnostic impressions.
The interpretation must be specific to what was examined. A limited exam report should focus on the targeted organs, not provide detailed descriptions of structures that weren’t included in the exam.
The radiologist signs and dates the report. Without a signed interpretation, the exam isn’t considered complete and insurance may deny payment.
Billing CPT Code 76705 Correctly
Correct billing requires attention to several details beyond just using the right CPT code. Each element of the claim must be accurate for proper payment.
Professional vs Technical Components
Ultrasound billing has two parts: the technical component and the professional component. The technical component covers the cost of performing the exam, including the equipment, technician time, and supplies. The professional component covers the physician’s work interpreting the images.
When one facility does both parts, you bill the global code 76705 without modifiers. This is common in hospitals and imaging centers that employ both technicians and radiologists.
When the work is split between facilities, you use modifiers to show which component you’re billing. The facility that performs the exam bills 76705-TC (technical component only). The physician who interprets the images bills 76705-26 (professional component only).
| Billing Situation | Code to Bill | Who Bills It |
| Complete service at one facility | 76705 | The facility |
| Only performing the exam | 76705-TC | The imaging center |
| Only reading the images | 76705-26 | The radiologist |
Getting this wrong causes payment problems. If you bill the global code but another facility is billing a component, insurance sees duplicate charges and denies one or both claims.
Diagnosis Codes Required
Every 76705 claim needs at least one diagnosis code explaining why the test was medically necessary. These codes come from the ICD-10 system and describe symptoms, diseases, or other medical reasons.
Common diagnosis codes used with 76705 include codes for abdominal pain, abnormal liver function tests, known gallstones being monitored, or kidney disease. The diagnosis must match what the ordering provider documented as the reason for the test.
Using vague or unrelated diagnosis codes invites denials. If the order says the patient has right upper belly pain but you bill with a code for knee pain, the claim will be rejected for not showing medical necessity.
Place of Service Codes
The place of service code tells insurance where you performed the ultrasound. Different locations use different codes, and some affect reimbursement rates.
| Location | Place of Service Code |
| Hospital outpatient | 22 |
| Freestanding imaging center | 11 |
| Doctor’s office | 11 |
| Emergency room | 23 |
Hospitals usually receive lower reimbursement for the professional component because they bill separately for facility fees. Freestanding centers typically receive higher rates for the technical component since they bear all equipment and overhead costs.
Using the wrong place of service code can result in incorrect payment amounts or outright denials if the code doesn’t match where you actually performed the service.
Insurance Reimbursement for CPT Code 76705
Payment for ultrasound services varies widely based on insurance type, geographic location, and whether you’re billing the complete service or just one component.
Medicare Payment Rates
Medicare sets rates using the Physician Fee Schedule. The rates differ by location using geographic adjustment factors. Urban areas typically have higher rates than rural areas.
For 76705, Medicare payment in 2024 averages around $50 to $70 for the professional component and $80 to $120 for the technical component in most areas. These are approximate ranges since exact amounts vary by locality.
Medicare requires that you accept assignment, meaning you agree to accept their payment as full payment except for any deductible or coinsurance the patient owes. You cannot balance bill Medicare patients for amounts above what Medicare allows.
Private Insurance Rates
Private insurance companies negotiate rates individually with providers. In-network rates are predetermined in your contract. Out-of-network rates depend on what the insurance allows for out-of-network services.
| Insurance Type | Typical Total Reimbursement |
| Medicare | $130 – $190 |
| Medicaid | $80 – $150 |
| Commercial in-network | $150 – $300 |
| Commercial out-of-network | $200 – $400 |
These ranges represent what you might see for the complete service. Actual rates depend heavily on your location and specific payer contracts.
Some insurance plans require prior authorization before they’ll pay for ultrasounds. Performing the exam without getting authorization first results in denied claims even if the service was medically necessary.
Patient Responsibility
Patients may owe copays, coinsurance, or deductible amounts depending on their insurance plan. High-deductible plans mean patients pay the full cost until they meet their deductible.
Collect patient payments at the time of service when possible. Trying to collect after the patient leaves is harder and more expensive. Many imaging centers require payment of estimated patient responsibility before performing the exam.
Common Billing Errors with 76705
Mistakes in coding and billing ultrasounds cost practices money through denied claims and compliance problems. Learning common errors helps you avoid them.
Using 76705 for Complete Exams
The most frequent error is billing 76705 when the technician actually performed a complete abdominal ultrasound. This happens when staff don’t understand the difference between limited and complete exams or when they default to using 76705 for all abdominal ultrasounds.
If your documentation shows images of all major abdominal organs, you performed a complete exam. Bill 76700, not 76705. Consistently billing limited exams when performing complete exams constitutes underbilling and leaves money on the table.
The reverse error also happens. Billing 76700 when only specific organs were examined is overbilling. This creates bigger problems since it suggests you’re trying to get paid more than you earned.
Missing or Incorrect Modifiers
Forgetting to add the TC or 26 modifier when billing only one component causes claim denials or incorrect payments. Insurance systems expect to see these modifiers when services are split between providers.
Adding modifiers when you shouldn’t also creates problems. If you perform both the exam and interpretation, bill the global code without modifiers. Adding a modifier incorrectly makes it look like you’re only billing for part of the service.
| Error | What Happens | How to Fix |
| Bill 76705 for complete exam | Underpayment | Use 76700 instead |
| Bill 76700 for limited exam | Overbilling, audit risk | Use 76705 instead |
| Forget TC modifier | Claim denied or wrong payment | Add appropriate modifier |
| Use modifier on global service | Underpayment | Remove modifier |
Diagnosis Code Mismatches
The diagnosis code must match the clinical indication on the order. If the doctor ordered the ultrasound for abdominal pain but you bill with a diagnosis code for diabetes, the claim may deny for lack of medical necessity.
Using outdated ICD-10 codes causes automatic rejections. The diagnosis code system updates every year on October 1st. Codes get added, deleted, or changed. Using a code that no longer exists results in immediate denial.
Multiple Ultrasounds on the Same Day
Sometimes a patient needs more than one ultrasound on the same day. How you bill these situations depends on what was examined and why.
Different Anatomic Areas
If a patient gets an abdominal ultrasound and a pelvic ultrasound on the same day, you bill both codes. These are different anatomic areas and different exams. No modifiers are needed because they’re distinct services.
The documentation must clearly show why both exams were medically necessary on the same day. Insurance companies may question multiple imaging studies without good clinical reasons.
Same Area, Different Times
Rarely, a patient might need two ultrasounds of the same area on the same day. For example, an initial exam might show something unclear, and after the patient drinks water or changes position, you repeat the exam.
Bill the second exam with a modifier 76 (repeat procedure by same physician) or 77 (repeat procedure by different physician). This tells the insurance company you intentionally performed the exam twice and it wasn’t a billing mistake.
Bilateral Organs
When examining paired organs like kidneys, one limited exam code covers both sides. You don’t bill 76705 twice for looking at both kidneys. The code includes examination of bilateral structures when appropriate.
However, if one kidney is examined on one day and the other kidney on a different day, each date of service gets its own claim.
Prior Authorization Requirements
Many insurance companies require prior authorization before they’ll pay for ultrasounds. This means getting approval from the insurance company before performing the test.
Which Payers Require Authorization
Medicare typically doesn’t require prior authorization for medically necessary ultrasounds, though some Medicare Advantage plans do. Check each plan’s specific requirements.
Medicaid authorization requirements vary by state. Some states require authorization for all imaging. Others only require it for high-cost tests. Your state Medicaid provider manual explains the rules.
Private insurance companies each have their own policies. Some require authorization for all diagnostic imaging. Others only require it for expensive tests like CT scans and MRIs but not for ultrasounds.
| Insurance Type | Authorization Usually Required? |
| Original Medicare | No |
| Medicare Advantage | Sometimes |
| Medicaid | Varies by state |
| Commercial PPO | Sometimes |
| Commercial HMO | Usually yes |
How to Get Authorization
The ordering provider’s office usually requests authorization, not the imaging facility. However, some practices require the imaging center to verify authorization before scheduling.
Authorization requests include the patient’s information, the requested test, the diagnosis, and supporting clinical information. Insurance companies review the request and either approve it, deny it, or ask for more information.
Keep the authorization number with your billing documentation. Include it on the claim when you submit. If the insurance company later questions payment, the authorization number proves you had approval.
Performing Exams Without Authorization
If you perform an ultrasound that needed authorization but you didn’t get it, the insurance company will deny the claim. They may also refuse to authorize it retroactively.
When this happens, the patient may be responsible for the full cost. Your practice policies should clearly state that patients are responsible for payment if their insurance denies due to missing authorization.
Some practices choose to write off these charges rather than bill patients for staff mistakes. This is a business decision each practice makes based on their philosophy and financial situation.
Quality and Compliance Standards
Ultrasound facilities must meet quality standards set by various organizations. Compliance with these standards affects your ability to bill and receive payment.
Accreditation Requirements
Many insurance companies require that ultrasound facilities be accredited by approved organizations. The American College of Radiology, Intersocietal Accreditation Commission, and American Institute of Ultrasound in Medicine all offer accreditation programs.
Accreditation involves submitting documentation about your equipment, personnel qualifications, quality control procedures, and sample cases for review. The process takes several months and must be renewed periodically.
Some states require accreditation by law. Others leave it up to insurance companies to decide if they’ll pay for non-accredited facilities. Medicare doesn’t require accreditation for ultrasound services, but Medicare Advantage plans might.
Equipment Standards
The ultrasound equipment must be appropriate for the exams you perform. Old or poorly maintained equipment produces poor quality images that may miss diagnoses.
Regular maintenance and quality control testing keep equipment working properly. Document these activities in case auditors ask about your quality assurance program.
| Compliance Area | Requirement | Who Checks It |
| Facility accreditation | Meet standards of approved organization | Insurance companies |
| Equipment quality | Properly maintained and calibrated | Accrediting bodies |
| Personnel credentials | Appropriate licenses and certifications | State boards, payers |
| Documentation | Complete and accurate records | Auditors |
Personnel Qualifications
Ultrasound technicians should have appropriate credentials. The American Registry for Diagnostic Medical Sonography offers certification in various specialties. Many employers and insurance companies prefer or require certified technicians.
Physicians interpreting ultrasounds must have proper training and credentials. Radiologists typically interpret imaging studies, but other specialists may interpret ultrasounds in their area of expertise. For example, cardiologists interpret echocardiograms.
State medical boards regulate physician practice. Some states have specific requirements for physicians who interpret imaging studies. Verify your state’s requirements to avoid practicing outside your scope.
Handling Denials and Appeals
Even with correct coding and complete documentation, claims sometimes get denied. Understanding how to respond effectively protects your revenue.
Reading Denial Reasons
Insurance companies send explanation of benefits forms or electronic remittance advice showing which claims they paid and which they denied. Each denial includes a code explaining the reason.
Common denial reasons for ultrasound claims include missing authorization, medical necessity not established, incomplete documentation, or services considered bundled with another procedure.
Understanding the specific reason helps you fix the problem. Authorization denials require getting retroactive authorization or appealing based on emergency circumstances. Medical necessity denials need additional clinical documentation supporting the need for the test.
Gathering Appeal Documentation
Appeals require submitting documentation that addresses the denial reason. For medical necessity denials, include the ordering provider’s notes explaining why the ultrasound was needed, any relevant lab results or prior imaging, and the ultrasound report showing what was found.
For authorization denials, include documentation of when you requested authorization, any emergency circumstances that prevented prior authorization, or evidence that authorization requirements weren’t clearly communicated.
Write a clear cover letter explaining why the claim should be paid. Reference specific policy language that supports coverage. Keep your tone professional and focus on facts rather than emotions.
| Denial Type | Appeal Strategy | Documents Needed |
| Missing authorization | Show emergency or prior approval attempt | Authorization request, clinical notes |
| Medical necessity | Demonstrate need for test | Ordering notes, prior results, clinical guidelines |
| Incorrect coding | Prove code was correct | Documentation supporting code selection |
| Timely filing | Show claim was timely or good cause for delay | Proof of submission date or delay reason |
Following Up on Appeals
Submit appeals by the deadline stated on the denial notice. Missing the deadline usually means you lose appeal rights and must write off the charge.
Track your appeals in a spreadsheet or practice management system. Note the submission date, expected response timeframe, and actual outcome. This tracking helps you follow up if you don’t receive a response.
Insurance companies must respond to appeals within specific timeframes set by state or federal law. If they don’t respond on time, you can escalate to a higher appeal level or file complaints with state insurance regulators.
Teaching Staff to Code 76705 Properly
Staff training prevents billing errors and improves claim acceptance rates. Everyone involved in the ultrasound process should understand their role in proper coding and billing.
Training Technicians
Ultrasound technicians need to understand the difference between limited and complete exams. They should know which organs to scan based on the order and how to document what they examined.
Train technicians to read orders carefully and ask questions if an order is unclear. An order that says “abdominal ultrasound” without specifying limited or complete requires clarification before the exam starts.
Technicians should document accurately. The technical report should list every structure they scanned. This documentation determines which code the billing department uses.
Training Billing Staff
Billing personnel need to match the CPT code to what the documentation shows was actually done. They should review both the technical report and the interpretation before coding.
Teach billing staff to recognize when documentation supports 76700 versus 76705. They should understand modifiers and when to use them. They need to know which insurance companies require authorization and how to verify it was obtained.
Regular audits of billed claims help identify patterns that need correction. Review a sample of claims monthly to catch systematic errors before they become large problems.
Creating Clear Protocols
Written protocols standardize how your practice handles ultrasound ordering, performing, and billing. Protocols should cover what information must be on orders, how technicians document exams, and how billing staff code different scenarios.
Update protocols when billing rules change. Communicate updates to all staff through meetings or written notices. Make sure everyone knows where to find current protocols when they have questions.
Managing Contracts and Reimbursement
Negotiating good contracts with insurance companies directly affects how much you collect for ultrasound services.
Understanding Your Contracts
Review your payer contracts to know your negotiated rates for 76705. Contracts specify payment amounts, usually as a percentage of Medicare rates or as fee schedules listing specific amounts for each code.
Contracts also contain other important terms like timely filing limits, appeal processes, and credentialing requirements. Understanding these terms helps you comply with contract obligations and protects your right to payment.
Some contracts include fee schedule updates tied to Medicare rate changes. Others lock in specific rates for the contract term. Know which type you have so you can track whether your payments match contracted amounts.
Negotiating Better Rates
When contracts come up for renewal, you have an opportunity to negotiate better rates. Prepare by researching what other providers in your area receive and calculating your costs to provide the service.
Present data showing the value you provide. If you have short wait times, high patient satisfaction scores, or accreditation from respected organizations, use this information to support requests for higher rates.
Be willing to walk away from contracts that don’t cover your costs. Some insurance companies offer rates so low that accepting them loses money on every exam. Dropping these contracts may be better for your practice’s financial health.
| Contract Element | What to Check |
| Reimbursement rates | Compare to costs and competitors |
| Timely filing limits | Verify you can meet deadlines |
| Appeal rights | Understand dispute resolution process |
| Credentialing requirements | Confirm you meet standards |
| Update frequency | Know when rates change |
Monitoring Payments
Don’t assume insurance companies pay correctly. Compare payments received to contracted rates regularly. Underpayments happen due to system errors, incorrect processing, or payers ignoring contract terms.
When you find underpayments, contact the insurance company promptly. Provide your contract and documentation showing what you should have received. Most companies will correct clear payment errors, though you may need to be persistent.
Track patterns in payment problems. If one insurance company consistently underpays or takes excessive time to process claims, document these issues for your next contract negotiation or consider dropping their contract.
Working with Referring Providers
Good relationships with ordering providers lead to steady referral volume and smoother operations.
Education About Appropriate Orders
Help referring doctors understand when to order limited versus complete abdominal ultrasounds. Provide simple guidelines they can reference when making decisions.
Clear communication prevents problems. If an order is inappropriate or unclear, contact the ordering provider before performing the exam. It’s better to delay the test slightly than to perform the wrong exam.
Some practices create order sets or protocols with referring providers. For common clinical scenarios, you agree in advance what type of exam is appropriate. This speeds ordering and reduces back-and-forth communication.
Providing Timely Results
Referring providers want fast results so they can make treatment decisions. Aim to have interpretation reports available within 24 hours for routine exams and within hours for urgent cases.
Fast turnaround times keep referring providers happy and encourage them to continue sending patients to your facility. Slow reporting drives referrals to competitors.
Make reports easy to access. Electronic delivery through health information exchanges or patient portals works better than faxing or mailing paper reports.
Handling Problem Cases
Sometimes ultrasound findings require immediate communication with the referring provider. Don’t wait for the written report if you find something urgent like a large abdominal mass or severe organ abnormality.
Call the ordering provider directly when findings need prompt attention. Document this communication in your report. Follow up to confirm they received the message and have a plan for the patient.
Future Changes in Ultrasound Billing
Healthcare billing continues to change. Staying informed about coming changes helps you prepare and adapt.
Transition to Value-Based Payment
Healthcare is slowly moving away from fee-for-service payment toward value-based models. Instead of paying for each test performed, some contracts pay based on keeping patients healthy and achieving quality metrics.
Ultrasound services may become part of bundled payments where one payment covers all services for an episode of care. This changes how you think about revenue since you share in savings or losses rather than billing for each individual service.
These changes are happening slowly and won’t replace traditional billing completely in the near future. However, understanding value-based payment helps you prepare for eventual changes.
Technology Improvements
Artificial intelligence is beginning to assist with ultrasound interpretation. AI programs can identify certain abnormalities and help radiologists work faster. This technology may eventually affect coding and billing practices.
Point-of-care ultrasound performed by non-radiologists is growing. Emergency physicians, hospitalists, and other specialists increasingly perform limited ultrasounds themselves. This expansion may affect referral patterns and where ultrasound billing occurs.
Portable ultrasound devices are becoming smaller and cheaper. These devices make ultrasound available in more settings, potentially increasing overall usage of codes like 76705.
How Billing Companies Help with 76705
Managing ultrasound billing in-house takes time and expertise. Many imaging centers and medical practices outsource billing to specialized companies.
Professional billing services know the specific requirements for imaging codes. They stay current on payer policy changes, authorization requirements, and documentation standards. This expertise reduces denials and speeds payment.
Faster Claims Processing
Billing companies submit claims quickly after receiving documentation. They have systems to track which reports are ready for billing and submit claims daily rather than letting them pile up.
Fast submission means faster payment. Money arrives in your account sooner, improving cash flow. You also avoid approaching timely filing deadlines that could cause claims to be denied.
Authorization Management
Many billing companies handle prior authorization requests as part of their service. They track which payers require authorization, submit requests with proper clinical information, and follow up on pending requests.
This service prevents performing exams without authorization. Staff don’t need to learn different authorization processes for dozens of insurance companies. The billing company’s expertise reduces authorization denials.
Appeal Expertise
When denials occur, billing companies handle appeals efficiently. They know what documentation payers need and how to present information for the best chance of success.
Their experience with appeals means higher overturn rates. They win appeals that practices might lose or not pursue due to lack of time or knowledge.
Compliance Protection
Billing companies monitor regulatory changes affecting imaging codes. They update their processes when rules change and alert clients about compliance requirements.
This oversight reduces your risk of billing violations that could trigger audits or penalties. The billing company’s compliance systems protect your practice from costly mistakes.
Cost Considerations
Billing companies typically charge a percentage of collections, usually 4% to 8% for imaging services. You only pay when they collect money, aligning their incentives with yours.
Compare this cost to hiring dedicated billing staff. Staff salaries, benefits, training, and overhead often exceed what billing companies charge, especially for smaller practices.
Larger facilities might find in-house billing more economical, but they still often outsource specific functions like appeals management or credentialing while handling routine billing internally.
When to Consider Outsourcing
Consider professional billing services if you experience high denial rates, slow collections, or difficulty keeping up with changing payer requirements. These signs suggest billing isn’t getting the attention it needs.
Small practices and independent imaging centers usually benefit most from outsourcing. They gain access to billing expertise without the overhead of maintaining full billing departments.
The right billing partner improves collections while freeing your staff to focus on patient care and operations rather than fighting with insurance companies.
Understanding CPT Code 76705 thoroughly helps whether you handle billing yourself or work with a billing company. Proper documentation, accurate coding, and knowledge of payer requirements create the foundation for successful billing. Combining strong internal processes with professional billing support gives you the best chance of collecting appropriate payment for the diagnostic imaging services you provide.
