Is telehealth modifier 95 or GT?

Asked by: Mabel Schroeder DDS  |  Last update: November 2, 2025
Score: 4.6/5 (5 votes)

Both Modifier 95 and the GT modifier indicate synchronous telehealth, but they are not always interchangeable: Modifier 95 is generally preferred by commercial insurers and Medicaid for most telehealth services. It's often used with codes listed in Appendix P of the CPT manual.

What is the difference between telehealth modifier GT and 95?

The two most commonly used modifiers are the GT modifier for telehealth service rendered via interactive audio and video telecommunications systems, and the 95 modifier for synchronous telemedicine service rendered via a real-time interactive audio and video communications system.

Do you use 95 or GT modifier for telehealth 2024?

For institutional billing, use modifier 95 for dates of service on and after January 1, 2024, through December 31, 2024, when: The clinician is in the hospital and the patient is in their home. Outpatient therapy provided via telehealth by PTs, OTs or SLPs employed by hospitals.

Does UHC require a 95 modifier for telehealth?

UnitedHealthcare requires one of the telehealth-associated modifiers (GT, GQ, G0 or 95) to be reported when performing a service via Telehealth to indicate the type of technology used and to identify the service as Telehealth.

What is modifier 95 or GT Aetna?

When a provider reports modifier GT or 95, it certifies the patient received services via an audiovisual telecommunications system. • GT: Telehealth service rendered via interactive audio and. video telecommunications system. • 95: Synchronous telemedicine service rendered via real-time.

What is a GT Modifier?

20 related questions found

Is Aetna no longer covering telehealth?

Aetna recently announced it was excluding fully insured commercial plans in all 50 states from its new telehealth policy that took effect December 1, 2023, eliminating coverage for audio-only and asynchronous telehealth services.

What POS do you use for telehealth?

Place of Service codes: When billing telehealth claims, it is important to understand the place of service (POS) codes as it affects reimbursement. POS 02 refers to telehealth provided other than in patient's home and POS 10 refers to telehealth provided in patient's home.

What is the correct modifier for telehealth?

Who uses the GT Modifier? The GT modifier is a coding modifier that is most commonly used for telehealth claims. According to the AMA, the modifier means “via interactive audio and video telecommunications systems.

What is the telehealth modifier for Cigna?

General virtual care guidelines

Please visit CignaforHCP.com/virtualcare for additional information about that policy. For all virtual care services, providers should bill using a reimbursable face-to-face code, append the GQ, GT or 95 modifier, and use POS 02 as of July 1, 2022.

How to code a telehealth visit?

Coding for Telehealth and Other Outpatient Remote Services
  1. 99202-99205: Office/outpatient E/M visit, new patient.
  2. 99211-99215: Office/outpatient E/M visit, established patient.
  3. G0425-G0427: Consultations, emergency department or initial inpatient (Medicare only)

How to bill for telehealth for behavioral health?

Most Commonly Used Mental Health Telehealth CPT Codes
  1. 98000-98003: New client audio-video telemedicine visits.
  2. 98004-98007: Established client audio-video telemedicine visits.
  3. 98008-98011: New client audio-only telemedicine visits.
  4. 98012-98015: Established client audio-only telemedicine visits.

What is the difference between telehealth and telemedicine?

While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. There are several other ways to define telehealth.

Will Medicare pay for telehealth in 2025?

Medicare patients can receive telehealth services for non-behavioral/mental health care in their home through March 31, 2025. There are no geographic restrictions for originating site for Medicare non-behavioral/mental telehealth services through March 31, 2025.

How to bill telehealth in 2024?

Coding for Audio-video Visits

Use the POS that aligns with the patient's location. As of January 1, 2024, Medicare pays telehealth services provided in the patient's home (POS 10) at the non-facility rate. Telehealth services provided at an originating site (POS 02) are paid at the facility rate.

Does Medicare require modifier 95 for telemedicine in 2024?

Telehealth Billing Change

Therapy providers, including SLPs, will continue to use modifier “95” to indicate telehealth services and will not use one of the POS codes for telehealth services, regardless of settings.

Is telehealth ending in 2024?

We continue to carefully consider the input received and are working to promulgate a final set of telemedicine regulations. However, with the end of 2024 quickly approaching, DEA, jointly with HHS, has extended current telemedicine flexibilities through December 31, 2025.

Does UHC require 95 modifier for telehealth?

Modifiers 95, GT, GQ and G0 are not required to identify Telehealth services but are accepted as informational if reported on claims with eligible Telehealth services.

What is modifier GT used for?

Modifiers in medical billing are two-digit codes used to provide specific details about a procedure or service provided to a patient. A GT modifier is a code used in medical billing to show administration of services through telemedicine.

What is the telehealth modifier for 90837?

So, you would use the CPT Code 90837 Modifier 95 for virtual sessions that are 53 minutes or longer. To further maximize your reimbursement, include the appropriate extender code if the session exceeds 53 minutes.

Can you bill 99213 for a telehealth visit?

During the COVID-19 public health emergency, many physiatrists are performing standard office visits via telehealth. These services should be billed using standard E/M codes. For example, a level 3 office visit provided to an established patient via telehealth should be billed using code 99213.

Can you bill a preventive visit via telehealth?

Yes, billable providers may utilize a telehealth modality to provide FQHC, RHC, or Tribal 638 covered services via synchronous telehealth (audio-visual, two-way communication) to “established” patients. Please see the Provider Manuals provided by telehealth.

What is the GN GO or GP modifier?

Modifiers GN, GO, and GP refer only to services provided under plans of care for physical therapy, occupational therapy and speech-language pathology services. They should never be used with codes that are not on the list of applicable therapy services.

What is the 95 modifier for telehealth?

The modifier may depend on the type of service. -95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.

What are options for telehealth?

There are different ways to use telehealth: Talk to your health care provider on the phone or using video. Send and get messages from your health care provider. Use tools to collect your health data.