Radiology Billing Services
in Connecticut

The Roadblocks to Radiology Profitability

Radiology revenue is becoming increasingly complex in 2026. High patient volumes, evolving payer rules, and advanced imaging technology have made reimbursement more challenging than ever. Even small coding, authorization, or documentation errors can delay payments, trigger denials, and reduce overall profitability. Below are the most critical roadblocks radiology providers encounter today.

• Prior Authorization Bottlenecks

  Advanced imaging and interventional procedures often require pre-certification. Delays or missing authorizations remain the leading cause of claim denials and revenue loss.

• Coding Complexity in Interventional Radiology (IR)

  IR procedures combine surgical and radiologic components, with CPT codes and bundling rules constantly evolving. Incorrect coding can result in claim rejections or reduced reimbursement.

• Professional & Technical Component Splits (PC/TC)

  Misapplication of PC and TC modifiers leads to underpayment or disputes, particularly when ownership, setting, and payer rules are inconsistent.

• No Surprises Act Compliance and Out-of-Network Disputes

  New legislation creates risk for denied claims, balance billing conflicts, and delayed payment when imaging services are out-of-network or payer communications are unclear.

• High Volume, High-Throughput Errors

  Large diagnostic imaging centers often experience errors in charge capture, CPT linkage, and patient demographic data due to high patient volumes, which increase AR days and administrative burden.

• Fragmented Workflow Across EHR and Billing Systems

  Disconnected technology platforms result in missed charges, delayed submissions, and inconsistent reporting, especially in centers that use multiple imaging modalities.

• Variable Payer Policies for Imaging Services

  Differences in coverage rules, bundled services, and modality-specific edits create unpredictable reimbursement and require specialized payer knowledge.