Modifier 95: Synchronous Telemedicine Service
Modifier 95 is used for synchronous telemedicine via real-time audio and video. Learn when modifier 95 is required vs. modifier GT for telehealth billing.
When to Append Modifier 95
Append to procedure codes delivered via real-time interactive audio and video when the CPT code has telehealth applicability. Check the AMA CPT telehealth appendix for eligible codes.
- Clinical notes must document that the service was performed via real-time synchronous audio and video.
- Asynchronous or audio-only services use different coding.
Source: AMA CPT® Modifier Guidelines / CMS
Modifier 95 in Detail
What does Modifier 95 cover in detail?
Modifier 95 is the synchronous telehealth modifier used by most commercial payers, functioning similarly to modifier GT for Medicare. both identify real-time audio-visual telehealth delivery.
See our telehealth billing guide for a full comparison of payer-specific telehealth modifier requirements and the billing modifiers reference for complete guidance.
Using Modifier 95 Correctly
How do I use Modifier 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.
Modifier 95 Reference
| Field | Details |
|---|---|
| Modifier | 95 |
| Full Name | Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System |
| When to Use | Append to procedure codes delivered via real-time interactive audio and video when the CPT code has telehealth applicability. Check the AMA CPT telehealth appendix for eligible codes. |
| Medicare Current Status | CMS adopted modifier 95 as the primary telehealth modifier for Medicare. This replaced or supplemented modifier GT for Medicare telehealth claims. |
| Documentation Requirement | Clinical notes must document that the service was performed via real-time synchronous audio and video. Asynchronous or audio-only services use different coding. |
| Key Distinction | Modifier 95 applies to synchronous (real-time) telehealth only. Audio-only visits use modifier 93 or specific audio-only CPT codes, not modifier 95. |
Source: AMA CPT® Modifier Guidelines / CMS
Related Billing Resources
Modifier 95, Frequently Asked Questions
Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System
Append to procedure codes delivered via real-time interactive audio and video when the CPT code has telehealth applicability. Check the AMA CPT telehealth appendix for eligible codes.
CMS adopted modifier 95 as the primary telehealth modifier for Medicare. This replaced or supplemented modifier GT for Medicare telehealth claims.
Clinical notes must document that the service was performed via real-time synchronous audio and video. Asynchronous or audio-only services use different coding.
Modifier 95 applies to synchronous (real-time) telehealth only. Audio-only visits use modifier 93 or specific audio-only CPT codes, not modifier 95.
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