Texas flag

Radiology Billing Services in Texas

Built for Novitas Solutions’ seven-state Jurisdiction H rules and a $116 billion Medicaid contract shakeup still working through the courts, we keep Texas radiology groups paid accurately and on time.

Radiology Billing Built For Texas's Realities

From the Metroplex to the Rio Grande Valley, Texas radiology groups bill against a seven-state Medicare jurisdiction, a Medicaid program mid-lawsuit over who gets to run it, and one of the steepest prompt pay interest penalties in the country.

Jurisdiction H Medicare rules shared with six other states

A $116 billion Medicaid contract award still tied up in court

18 percent annual interest on claims paid late

Compact-licensed physicians accepted since March 2022

Processed Claim Value
$ M+
Avg. A/R Collection Time
0 Days
Turn Around Time (TAT)
0 Hours
Client Retention Rate
0 %
Annual Claims
0 M+
First-Pass Claim Rate
0 %
Avg. Revenue Growth
8- 8 %
Avg. Denial Reduction
0 %

Texas's Regulatory Landscape

Texas radiology billing runs through a seven-state Medicare jurisdiction, a Medicaid contract still unsettled in court, and one of the country’s steepest prompt pay interest penalties.

Jurisdiction H Medicare Rules

Novitas Solutions processes Medicare Part A and B claims for Jurisdiction H, covering Texas, Arkansas, Colorado, Louisiana, Mississippi, New Mexico, and Oklahoma. A coverage update out of Colorado applies just as directly to a radiology group in Houston. We track Novitas’s specific bulletins so Texas claims match the standard actually enforced.

A Medicaid Contract Still in Court

Texas’s attempt to re-award roughly $116 billion in STAR and CHIP managed care contracts triggered a lawsuit from the losing plans, and a 2024 court injunction halted the switch before it reached the nearly 1.8 million members it would have moved. The litigation was still working through the courts as of the 89th Legislature, so which plan a Texas Medicaid patient’s imaging claim routes through can still change again.

A 2022 Compact Member

Texas joined the Interstate Medical Licensure Compact on March 1, 2022, becoming the 33rd member state under House Bill 1616. That speeds up getting a Texas license for a physician already licensed elsewhere, but a separate payer enrollment is still required before claims can be billed under that radiologist’s NPI, a step large multi-state groups often miss.

30/45-Day Prompt Pay Rule

Under Texas Insurance Code Chapters 1301 and 843, insurers must pay a clean electronic claim within 30 days and a paper claim within 45 days. Carriers that pay late owe 18 percent annual interest on the overdue amount, one of the steepest penalties of any state we bill in. We build Texas claims clean on the first pass so they clear inside that window.

Complete Radiology Revenue Cycle Management

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.

Where Texas Radiology Billing Breaks Down

A seven-state Medicare jurisdiction, a Medicaid contract fight still unresolved in court, and an 18 percent interest penalty on late claims all add friction most billing teams aren’t built to absorb.

Before RBS

Medicaid claims denied when a patient's plan changes mid-dispute

Jurisdiction H denials reworked from scratch every time

Compact licensing mistaken for payer enrollment

Electronic claims slipping past the 30-day deadline

18 percent interest penalties absorbed instead of collected

After RBS

Medicaid claims tracked against whichever plan is actually active

Jurisdiction H appeals built on tracked Novitas bulletins

Licensure and payer enrollment tracked as two separate steps

Every electronic claim timestamped against the 30-day deadline

Late-payment interest tracked and collected, not written off

Precision RCM & Coding Built for Radiology

Generic billing is the fastest way to a denied radiology claim. RBS delivers specialty-specific revenue integrity built for imaging’s TC/PC splits and modifier rules, so you capture every dollar you’re owed.

Diagnostic Radiology

CT Scan

MRI & MRA

Nuclear Medicine

PET / PET-CT

Ultrasound

Interventional Radiology

Teleradiology

Mammography

DEXA / Bone Density

Hospital Radiology

Radiation Oncology

Coverage Confirmed for Every Payer You Work With

From national carriers to regional Medicaid plans, coverage is checked against the exact payer, plan, and product type on file — never a generic match. Every result reflects current payer policy, not outdated data from months ago.
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana

Serving Radiology Practices Across Texas

From Houston and Dallas-Fort Worth to San Antonio, Austin, and El Paso, we bill for radiology groups and their hospital partners across the state.

Dallas-Fort Worth Metroplex

Cities
  • Dallas
  • Fort Worth
  • Arlington
Counties
  • Dallas County
  • Tarrant County

Houston & the Gulf Coast

Cities
  • Houston
  • Sugar Land
  • Pasadena
Counties
  • Harris County
  • Fort Bend County

San Antonio & South Central Texas

Cities
  • San Antonio
  • New Braunfels
  • Seguin
Counties
  • Bexar County
  • Comal County

Austin & the Hill Country

Cities
  • Austin
  • Round Rock
  • San Marcos
Counties
  • Travis County
  • Williamson County

El Paso & West Texas

Cities
  • El Paso
  • Midland
  • Odessa
Counties
  • El Paso County
  • Midland County

Rio Grande Valley & South Texas

Cities
  • McAllen
  • Brownsville
  • Laredo
Counties
  • Hidalgo County
  • Cameron County

Wired Into Every System You Already Run

Your EHR, RIS, and PACS stay exactly as they are. We plug our coding workflow directly into what you already use — no migration, no new login for your radiologists, no disruption to how your team already works.

Built for Texas's Dominant Private Payer

Health Care Service Corp, the parent of Blue Cross and Blue Shield of Texas, holds roughly 44 percent of the state’s commercial health insurance market, more than any other carrier. BCBS Texas is also one of the plans positioned to take on a large share of the state’s Medicaid business once the court fight over that contract resolves. A practice that can’t bill cleanly against BCBS Texas is exposed on both fronts at once.
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Frequently Asked Questions

What Medicare Administrative Contractor handles Texas radiology claims?

Novitas Solutions processes Medicare Part A and B claims for Jurisdiction H, which also covers Arkansas, Colorado, Louisiana, Mississippi, New Mexico, and Oklahoma. We track Novitas’s specific billing bulletins rather than generic national Medicare guidance.
Texas tried to re-award roughly $116 billion in STAR and CHIP contracts, and the losing plans sued over the scoring process. A 2024 injunction paused the switch before nearly 1.8 million members were moved, and the litigation was still unresolved as of the 89th Legislature. We track which plan is actually active for a given patient rather than assuming the award stands.
No. Texas joined the Interstate Medical Licensure Compact in March 2022, which speeds up getting a Texas medical license, but an out-of-state radiologist still needs that license and separate payer enrollment before claims can be billed under their NPI.
Insurers that miss the 30-day electronic or 45-day paper claim deadline under Texas Insurance Code Chapters 1301 and 843 owe 18 percent annual interest on the overdue amount, one of the highest prompt pay penalties of any state we bill in. We track every claim’s clock so that interest gets collected instead of waived.
Yes. Blue Cross and Blue Shield of Texas, through parent company Health Care Service Corp, covers roughly 44 percent of the state’s commercial market and is also positioned for a larger Medicaid role. We build claims to its specific requirements rather than treating it as a generic commercial payer.

Get Texas Radiology Billing That Keeps Up

From Jurisdiction H appeals to a Medicaid contract still working through the courts, let’s talk about what’s actually slowing down your reimbursements.

Jurisdiction H and Novitas-specific claim review

Medicaid claims tracked against the plan actually in force

Compact licensing and payer enrollment tracked end to end

Clean-claim tracking against the 30/45-day deadline

Commercial billing built for BCBS Texas's specific requirements

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What Our Clients Say?

Rebecca Lawson

★★★★★

Radiology Practice Manager

Since partnering with your radiology billing team, our billing workflow has become much smoother. They understand imaging procedures, payer requirements, coding, and claim follow-ups. Their team is responsive, professional, and always stays on top of outstanding claims.

Dr. Christopher Bennett

★★★★★

Medical Director, Diagnostic Imaging Center

Your team truly understands the challenges of radiology billing. They handle claims accurately, follow up on unpaid accounts, and help resolve billing issues efficiently. Their expertise and communication have made our revenue cycle more organized and reliable.

Dr. Andrew Whitaker

★★★★★

Radiologist & Imaging Center Owner

Our team has been an excellent partner for our imaging center. They understand radiology billing, coding, claim submission, denials, and follow-ups. Their attention to detail and consistent communication have helped streamline our billing process and improve our revenue cycle.

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