07/06/2026
Telehealth modifiers are not interchangeable — and that is where many billing issues begin.
Telehealth continues to be a valuable option for patients and providers, but from a billing perspective, the details matter. One of the biggest areas of confusion is knowing which telehealth modifier applies and why.
Here is a quick breakdown:
Modifier 95
Used for a synchronous telemedicine service provided through real-time audio and video communication. This is commonly used when the provider and patient are interacting live through a telehealth platform.
Modifier 93
Used for a synchronous audio-only telemedicine service. This applies when the encounter is real-time, but conducted by telephone or another audio-only platform.
Modifier GT
Historically used to indicate an interactive audio and video telecommunication service. Some payers may still require it, but it is not universally accepted the way it once was. This is one to verify payer-by-payer.
Modifier GQ
Used for asynchronous telecommunication, often referred to as “store and forward.” This means information is transmitted and reviewed later, rather than the provider and patient communicating live at the same time.
Modifier FQ
Used to identify certain audio-only telehealth services, especially in Medicare contexts such as Rural Health Clinics and Federally Qualified Health Centers.
And don’t forget: modifiers are only part of the equation.
The Place of Service code is just as important. For Medicare telehealth claims, POS 02 is used when telehealth is provided somewhere other than the patient’s home, while POS 10 is used when the patient receives telehealth services in their home. CMS has specifically tied POS selection to reimbursement methodology, so this is not just a technicality.
The bottom line:
Telehealth billing is not a “set it and forget it” process. The correct modifier depends on the payer, the technology used, the patient’s location, the provider type, and the service performed.
A clean telehealth claim starts with three questions:
Was the visit audio/video or audio-only?
Where was the patient located?
What does the payer require?
Getting those answers right on the front end can prevent denials, rework, delayed reimbursement, and compliance risk.
Telehealth billing does not have to feel like a moving target. If your practice needs help reviewing modifier usage, payer requirements, or claim denials, Sunrise Services is here to help. Let’s make sure your telehealth claims are clean, compliant, and paid correctly.
Read the FAQ page from CMS here:
https://conta.cc/4avhuOY
