Radiology Billing Solutions (RBS) is a revenue cycle management company built exclusively for radiology departments, imaging centers, and teleradiology practices nationwide. As a dedicated PET and PET-CT billing partner, we handle prior authorizations, tracer coding, credentialing, and denials — so your techs and radiologists can focus on scans and patient care instead of chasing payers.
Across the industry, denial rates on PET and PET-CT run higher than almost any other imaging modality, driven by strict NCD coverage criteria, prior authorization gaps, and tracer documentation issues. Every one of those denials is money your center already earned. These are the six issues behind most of it, and the ones our workflow exists to close before they cost you.
PET and PET-CT scans require prior authorization on nearly every payer, tied to National Coverage Determination (NCD) criteria for the oncologic indication. A missed authorization or NCD mismatch stalls payment before the scan happens.
The FDG tracer dose is billed under its own HCPCS code, separate from the PET-CT procedure. Payers frequently deny or underpay tracer charges when the dosage documentation, waste log, or NDC number doesn’t match what was billed.
Billing a PET-CT as two separate scans instead of one combined study, or missing the correct bundling modifier for the CT attenuation-correction component, are coding slips that trip Medicare’s NCCI edits — and they’re almost always preventable.
PET is covered only for specific oncologic, cardiac, and neurologic indications defined by NCD 220.6. When the ordering diagnosis doesn’t clearly match a covered indication, payers deny for medical necessity — even on an appropriate scan.
High-performing PET billing keeps claims moving through the cycle in 30–40 days. Without dedicated follow-up, unpaid and underpaid claims sit longer, and revenue your center already earned stays parked on the books instead of in it.
Missing NCD-required documentation, incomplete radiopharmaceutical waste logs, or thin oncologic staging notes aren’t just denial risks — they’re exactly the patterns payer and Medicare auditors are trained to flag first.
Certified CIRCC and CPC coders handle every CPT code, modifier, and global billing rule specific to diagnostic and interventional radiology — maximizing reimbursement on every encounter across all modalities and payer types.
We manage payer credentialing and enrollment for radiologists, imaging centers, and IR practices. CAQH management and timely revalidations keep providers in-network without delays.
We verify patient coverage and imaging benefits before every scan is scheduled. Our team flags missing prior authorizations and AUC gaps early, preventing denials and protecting your revenue upfront.
We manage your complete revenue cycle — from charge entry and claims submission to payment posting and denial resolution — improving collections and shortening days in A/R.
Our certified coders apply precise CPT and ICD-10 codes across X-ray, CT, MRI, and ultrasound claims. Correct TC/PC/Global splits ensure faster reimbursements and fewer claim rejections.
Our team handles scheduling, patient intake, insurance verification, and pre-authorization coordination so your front desk runs smoothly and imaging appointments stay on track.
We audit your billing and coding processes to uncover missed charges, compliance gaps, and revenue leakage — giving you a clear roadmap to recover lost revenue.
Our CIRCC- and CPC-certified coders work across the full PET and PET-CT code set every day, applying the correct NCD coverage criteria, tracer billing rules, and bundling edits for each indication. Here are 8 of the codes we code and defend most often:
PET and PET-CT centers choose RBS because we speak the language of oncologic imaging — NCD coverage criteria, tracer billing, and payer rules that change by indication. That depth is what keeps your claims clean and your cash flow predictable.
Authorizations submitted and tracked before the patient is scheduled, checked against NCD coverage criteria to reduce same-day cancellations and denied scans.
CIRCC- and CPC-certified coders trained specifically on PET CPT, radiopharmaceutical HCPCS, and NCD coverage rules.
We integrate with the imaging systems your center already runs, so there's no workflow disruption.
Real-time visibility into collections, denials, and A/R aging so you always know where your revenue stands.
A billing team that works exclusively with PET and PET-CT centers, not a generalist team treating NCD coverage rules as one detail among many.
Documentation and data handling built to withstand payer audits and regulatory review.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
HIPAA-compliant, audit-ready.
