When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), bill with:
- Place of Service (POS) equal to what it would have been had the service been furnished in-person
- Modifier 95, indicating the service rendered was actually performed via telehealth
- Alaska and Hawaii use asynchronous (Store and Forward) technology, use GQ modifier
- Furnished for diagnosis and treatment of an acute stroke, use GO modifier
There are no billing changes for institutional claims. Critical access hospital method II claims should continue to bill with modifier GT.
Medicare modifiers are:
- 95 – Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system
- Use of the 95 modifier indicates a real-time interaction between a physician or other qualified health care professional and a patient who is located at another site than his/her physician or other qualified health care professional or by him/herself.
- Modifier 95 may be appended to the services listed in Appendix P of the CPT Code Book or marked with a star in the code lists within the CPT Code Book.
- GQ – Via asynchronous telecommunications system (e.g., 99201-GQ)
- Use of the GQ modifier certifies an asynchronous telecommunications system was used, such as Store and Forward technologies, to transmit medical or behavioral health information to the provider at the “distant site.”
- GT – Via interactive audio and video telecommunication systems (e.g., 99201-GT)
- Use of the GT modifier certifies the member was present at an eligible “originating site” when the telehealth/telemedicine service was performed.
- This modifier is used exclusively by the “distant site” provider.
- G0 – Telehealth services for diagnosis, evaluation or treatment of symptoms of an acute stroke
- This modifier should be appended to both the originating and distant site provider services as clinically appropriate when billing for an acute stroke telehealth service.
- This modifier should be appended on services that were rendered or furnished in such sites as a hospital, critical access hospital or mobile stroke unit.
- Such services should also be billed with the appropriate POS code on professional claims to indicate telehealth service.