What is the modifier for audio-only telehealth visit?
Asked by: Mr. Hudson Cassin V | Last update: June 26, 2025Score: 4.5/5 (1 votes)
Is telehealth modifier 95 or GT?
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.
What is the modifier 93 or FQ?
-93: Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system. -GQ: Telehealth service rendered via asynchronous telecommunications system. -FQ: A telehealth service was furnished using real-time audio-only communication technology.
Does audio-only count as telehealth?
Medi-Cal covers synchronous telehealth (e.g., video synchronous interaction and audio-only synchronous interaction) and asynchronous telehealth (e.g., store and forward and e-consults) across multiple services and delivery systems, including physical health, dental, specialty and non-specialty mental health, and SUD ...
What is modifier 59 most commonly used for?
Modifier 59 Distinct Procedural Service indicates that a procedure is separate and distinct from another procedure on the same date of service. Typically, this modifier is applied to a procedure code that is not ordinarily paid separately from the first procedure but should be paid per the specifics of the situation.
Telehealth Modifiers You Might Not be Aware of FR, FQ, 93, and XE & 59, and are Audio Sessions Ok?
What is modifier 58 used for?
Modifier 58 is defined as a staged or related procedure performed during the postoperative period of the first procedure by the same physician. A new postoperative period begins when the staged procedure is billed.
When should modifier 57 be used?
Modifier -57 is appended to office visits the same day or within three days of a major surgery (90-day global period). It indicates the office visit includes the decision for the major procedure.
Does Medicare pay for audio-only telehealth?
The audio-only services are reimbursed at the same rates as in person services. These waivers and flexibilities have facilitated the widespread use of telehealth and other communication-based technologies.
What is the code for telehealth visit?
Telehealth Visit A visit with a provider that uses telecommunication systems between a provider and a patient. 99202 - 99215 For new* or established patients.
What is the QF modifier used for?
QF: Used if the documented flow requirement on an “at rest” qualifying test is >4 LPM, and portable oxygen is prescribed.
When to use modifier 92?
Alternative Laboratory Platform Testing: When laboratory testing is being performed using a kit or transportable instrument that wholly or in part consists of a single use, disposable analytical chamber, the service may be identified by adding modifier 92 to the usual laboratory procedure code (HIV testing 86701-86703) ...
What is a 73 modifier used for?
Modifier -73 is used by the facility to indicate that a surgical or diagnostic procedure requiring anesthesia was terminated due to extenuating circumstances or to circumstances that threatened the well being of the patient after the patient had been prepared for the procedure (including procedural pre-medication when ...
What is the modifier 93 for telehealth?
Modifier 93 descriptor
Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional.
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.
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.
When to use FQ modifier?
Append CPT modifier 93 to services provided via audio-only. Federally qualified health centers and rural health centers should use modifier FQ, 93, or both where appropriate and true, since they are identical in meaning.
What is audio telehealth?
A real-time interaction between a patient and health care provider that is conducted solely via audio (e.g., telephone, internet call without video).
What are the new telehealth guidelines for 2024?
Before the COVID-19 PHE, patients needed to get telehealth at an originating site located in a certain geographic location. Through December 31, 2024, all patients can get telehealth wherever they're located. They don't need to be at an originating site, and there aren't any geographic restrictions.
Does Medicare cover telehealth audio only?
Modality. Non-behavioral/mental telehealth services in Medicare can be delivered using audio-only communication platforms through March 31, 2025.
When to use modifier 95?
CMS and private payers regularly change their instructions about using these modifiers and what place of service to use. In 2024, CMS is no longer requiring modifier 95 on claims, but is requiring using POS 02 or POS 10. Modifier 95 is for use with real-time, audio/visual visits.
What does "audio only" mean?
Audio only means interactive, two-way audio communication that only uses sound that meets the requirements of the Health Insurance Portability and Accountability Act. Audio-only includes the use of telephonic communication.
What is modifier 53 used for?
Appropriate use modifier 53:
Bill modifier 53 with the CPT code for the service furnished. This modifier is used to report a service or procedure when the service or procedure is discontinued after anesthesia is administered to the patient.
Can you bill both a 25 and 57 modifier?
Both Major and Minor Surgeries on the Same Day When a decision for surgery includes both major and minor surgeries and is made the day of surgery, the E&M billed for the decision must have both modifier –57 and modifier –25 appended.
What is modifier 56 used for?
Modifier 56 is used for preoperative management only when a qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure.