What is modifier GT used for?

What is the GT modifier used for?

Modifiers help distinguish a telehealth visit from an in-person visit. 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.

How to bill for telehealth for behavioral health?

What is an example of a GP modifier?

GP Modifier Example:

If physical therapist provides a therapeutic exercise (CPT code 97110) in an outpatient setting, they would bill for this service as "97110-GP" to denote the provider of the service.

Who can bill with a GP modifier?

Used in conjunction with CPT® (Current Procedural Terminology) codes, the modifier “GP” shows that the therapy services were specifically provided by a physical therapist. This helps ensure accurate billing and reimbursement for physical therapy services under Medicare and other insurance company plans.

What insurance companies require the GP modifier?

The use of the GP modifier is required now on all claims to United Health Care and their affiliates, VA claims, Medicare claims, Blue Cross Blue Shield of Michigan and now Anthem Blue Cross of California.

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.

What POS should be used 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.

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 is the modifier for telehealth 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.

Can a chiropractor use GP modifier?

So if you render and bill for 1-2 regions of CMT (98940) and therapeutic exercise (97110), then the 97110 chiropractic CPT code will receive the GP modifier.

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.

When to add GP modifier?

Every service performed by a physical therapist (PT), occupational therapist (OT), or speech-language pathologist (SLP) requires a therapy modifier (GP, GO, GN) for claim submission. So in this scenario, you would affix the GP modifier to the claim.

Does telehealth need a modifier?

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.

Can doctors bill family members?

Spouse of grandparent and grandchild. Doctors cannot bill Medicare for treating these immediate relatives. They are also prohibited from billing for their relative's care under their partnership's or professional corporation's provider number.

Does Medicare require GP modifier?

On January 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released MLN Matters Number: MM10176. In this notice, CMS identified certain services subject to the therapy cap. The revision became effective on January 1, 2018.

Is there a modifier for covering physician?

The Q6 modifier, often referred to as the locum tenens modifier, is a billing code used in medical reimbursement to indicate that a substitute physician provided services.

Does UnitedHealthcare require GP modifier?

Effective with dates of service on or after July 1, 2020, UnitedHealthcare aligns with CMS and requires HCPCS modifiers GN, GO or GP to be reported with the codes designated by CMS as always therapy services.

What is the difference between GT and 95 modifier?

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.

Can you do telehealth for mental health?

Telehealth is an effective tool that expands access to behavioral health services. Telehealth use for behavioral health remains high. A survey of mental health treatment facilities found that 80% offered care via telehealth.

What is the CPT code 90837 GT?

CPT® code 90837: Psychotherapy, 1 | American Medical Association.