The modifiers are what breaks them down.

TC means the technical component of the CPT code is being billed and -26 modifier means the professional component of the same CPT is being billed.

No modifer means you are billing for both professional and technical components. If you look at the Medicare Reimbursement Manual, you will see that the reimbursement is different when no modifier is used, when modifier -26 is used or when TC modifier is used.

Make sure you are not unbundling a code in order to get paid. Also, always check your CCI edits and your local mediare review policies when a code is in question.

In regards to the Physician Scarcity Program, go to the Florida Medicare site: www.floridamedicare.com
Then go to Part B and search for provider scarcity. There you will see many articles regarding this, including the most recent Medicare B Update - 1Q-2005. This will give you the answers you seek.