Modifier GT vs 95: Which Telehealth Modifier to Use
GT vs 95 vs 93 telehealth modifiers compared. GT was eliminated on professional claims but remains on institutional claims. Full decision table.
GT-VS-95 in Detail
The short answer is that GT and 95 are no longer interchangeable, and the deciding factor is what kind of claim you are submitting. On professional claims the GT requirement was eliminated, with the telehealth place of service code now certifying that the service met telehealth requirements. On institutional claims there were no corresponding billing changes, so GT is still in use there.
That split is where most of the confusion comes from: two billers can both be correct while using different modifiers, because one is billing professionally and the other institutionally. The third modifier in the family, 93, separates audio-only encounters from audio and video ones. See modifier 95 and modifier GT for each in full. Getting the pairing wrong is a compliance exposure, not just a payment one, which is covered in medical billing compliance.
Using GT-VS-95 Correctly
When to Apply
Apply this modifier only when the clinical circumstances described in the modifier definition are present and documented in the medical record.
Procedure Code Compatibility
Confirm this modifier is applicable to the procedure codes being billed. Not all modifiers are valid with all CPT codes.
Documentation Support
Ensure the medical record supports the modifier's use. Auditors will review documentation to confirm the modifier is appropriate.
Payer Acceptance
Verify that the payer accepts this modifier and understand how it affects reimbursement before submitting the claim.
Telehealth Modifier Comparison: GT, 95 and 93
| Modifier | Meaning | Where It Applies |
|---|---|---|
| 95 | Synchronous telehealth delivered by audio AND video | Professional claims, paired with the telehealth place of service code. Also used where a clinician is in the hospital and the patient is at home, and for outpatient therapy delivered via telehealth. |
| 93 | Synchronous telehealth delivered by AUDIO ONLY | Used in place of 95 when the encounter had no video component. Choosing 95 for an audio-only visit misreports how the service was delivered. |
| GT | Interactive audio and video telecommunication | Requirement ELIMINATED on professional claims, where the telehealth place of service code now certifies the service. Still applicable on INSTITUTIONAL claims, where no corresponding billing change was made. |
| Place of service | Certifies the encounter as telehealth | Telehealth place of service codes must be paired with the appropriate modifier on the claim. On professional claims the POS is what establishes telehealth, which is why GT became redundant there. |
| Decision rule | Claim type first, then delivery method | Institutional claim: GT still applies. Professional claim: use the telehealth POS plus 95 for audio and video, or 93 for audio only. Confirm the specific payer, since commercial plans set their own requirements. |
| Payer variation | Commercial plans differ from Medicare | Medicare rules do not automatically apply to commercial or Medicaid managed care plans. Several still require GT on professional claims. Verify per plan before submitting rather than applying Medicare policy universally. |
Source: CMS and telehealth.hhs.gov, Medicare fee-for-service billing guidance
GT-VS-95, Frequently Asked Questions
The short answer is that GT and 95 are no longer interchangeable, and the deciding factor is what kind of claim you are submitting. On professional claims the GT requirement was eliminated, with the telehealth place of service code now certifying that the service met telehealth requirements. On institutional claims there were no corresponding billing changes, so GT is still in use there.
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