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 The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101.  Medicare guidance says, in this Manual, many policies are described using the term "physician". Unless otherwise indicated, the use of this term does not restrict the application of policies to physicians only. Rather, the policies apply to all practitioners, hospitals, providers, or suppliers eligible to bill the relevant HCPCS/CPT codes pursuant to applicable portions of the Social Security Act (SSA) of 1965, the Code of Federal Regulations (CFR), and Medicare rules. Physicians must report services correctly. This manual discusses general coding principles in Chapter I and principles more relevant to other specific groups of HCPCS/CPT codes in the other chapters. There are certain types of improper coding that physicians must avoid. You can find this guidance in the National Correct Coding Initiative Policy Manual, Chapter I - General Correct Coding Policies, Section A.   Medicare guidance says, Professional Component (PC)/Technical Component (TC) Indicator 3 = Technical component only codes: This indicator identifies stand-alone codes that describe the technical component (i.e., staff and equipment costs) of selected diagnostic tests for which there is an associated code that describes the professional component of the diagnostic tests only. An example of a technical component code is 93005, Electrocardiogram, tracing only, without interpretation and report. It also identifies codes that are covered only as diagnostic tests and therefore do not have a related professional code. Modifiers 26 and TC cannot be used with these codes. The total RVUs for technical component only codes include values for practice expense and malpractice expense only. You can find this guidance in the Medicare Claims Processing Manual, Chapter 23 - Fee Schedule Administration and Coding Requirements, Section 50.6 Physician Fee Schedule Payment Policy Indicator File Record Layout. On the Medicare web site CMS.gov, Physician Fee Schedule, PFS Relative Value Files the file 2021 National Physician Fee Schedule Relative Value File April Release lists HCPCS code Q0092 and R0070 with a PCTC Indicator of 3. Medicare guidance says as a result of SNF Consolidated Billing (Section 4432(b) of the Balanced Budget Act (BBA) of 1997), A/B MACs (B) may not pay for the TC of radiology services furnished to Skilled Nursing Facility (SNF) inpatients during a Part A covered stay. The SNF must bill radiology services furnished its inpatients in a Part A covered stay and payment is included in the SNF Prospective Payment System (PPS). Services furnished by portable x-ray suppliers may have as many as four components. A/B MACs (B) must follow the following rules. This component represents the transportation of the equipment to the patient. Establish local RVUs for the transportation R codes based on Medicare Administrative Contractor (MAC) knowledge of the nature of the service furnished. The MACs shall allow only a single transportation payment for each trip the portable x-ray supplier makes to a particular location. When more than one patient is x-rayed at the same location, e.g., a nursing home, prorate the single fee schedule transportation payment among all patients (Medicare Parts A and B, and non-Medicare) receiving the portable x-ray services during that trip, regardless of their insurance status. For example, for portable x-ray services furnished at a Skilled Nursing Facility (SNF), the transportation fee should be allocated among all patients receiving portable x-ray services at the same location in a single trip irrespective of whether the patient is in a Part A stay, a Part B patient, or not a Medicare beneficiary at all. If the patient is in a Part A SNF stay, the transportation and set up costs are subject to consolidated billing and not separately billable to Medicare Part B. For a privately insured patient, it would be the responsibility of that patient's insurer. For a Medicare Part B patient, payment would be made under Part B for the share of the transportation fee attributable to that patient. A/B MACs (B) must pay a set-up component for each radiologic procedure (other than retakes of the same procedure) during both single patient and multiple patient trips under Level II HCPCS code Q0092. A/B MACs (B) do not make the set-up payment for EKG services furnished by the portable x-ray supplier. When a SNF bills for portable x-ray equipment transported to a site by van or other vehicle, the SNF should bill for the transportation costs using one of the following HCPCS codes along with the appropriate revenue code: Code R0070, Description Transportation of Portable x-ray Equipment and Personnel to Home or Nursing Home, Per Trip to Facility or Location, One Patient Seen. NOTE: When a SNF resident receives a portable x-ray service during the course of a Medicare-covered stay in the SNF, only the service's professional component (representing the physician's interpretation of the test results) is a separately billable physician service under Part B (see Section 20.1 of this chapter and Section 20.1.1 of Chapter 6). By contrast, the technical component representing the procedure itself, including any associated transportation and setup costs, would be subject to consolidated billing (the SNF "bundling" requirement for services furnished to the SNF's Part A residents), and must be included on the SNF's Part A bill for the resident's covered stay (Bill Type 21x) rather than being billed separately under Part B (see Section 20.2.1 of this chapter). You can find this guidance in the Medicare Claims Processing Manual, Chapter 13 - Radiology Services and Other Diagnostic Procedures, Section 20.2.1- Hospital and Skilled Nursing Facility (SNF) Patients, Section 90 - Services of Portable X-Ray Suppliers, Section 90.3 - Transportation Component (HCPCS Codes R0070 - R0076), Section 90.4 - Set-Up Component (HCPCS Code Q0092) and Section 90.5 - Transportation of Equipment Billed by a SNF to a MAC.  If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.