Modifier GT Eliminated for Telehealth Services

Modifier GT Eliminated for Telehealth Services

Modifier GT via interactive audio and video telecommunications systems is no longer required on professional claims when reporting telehealth services for Medicare patients. Instead, the Centers for Medicare & Medicaid Services (CMS) instructs, “Use of the telehealth Place of Service (POS) Code 02 certifies that the service meets the telehealth requirements.”
An exception occurs for distant site services billed under Critical Access Hospital (CAH) method II on institutional claims. In these cases, modifier GT will still be required.
Note the American Medical Association created a new telehealth modifier in 2017 (modifier 95 Synchronous telemedicine service), but Medicare does not recognize this modifier. When billing payers other than Medicare for telehealth, be sure to check that payers guidelines to determine correct modifier use.

John Verhovshek
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About Has 586 Posts

John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

12 Responses to “Modifier GT Eliminated for Telehealth Services”

  1. Stephanie Foundas says:

    I would like to know the most up to date rule for billing telehealth for Medicaid patients for 2019.. Do we use the GT modifier or just the POS 2.

  2. Chris Mitchell says:

    I would like information on this as well.

  3. SHEENA WASHINGTON says:

    Same here – any updates would be most useful. Also, what about Medicaid T1014 and Q3014 – are these usable billing codes as well?

  4. Ellen rogers says:

    Is this the same for commercial insurance plans?

  5. Michele says:

    I am in Florida and would like to know how we are billing the H0004 with GT modifier or 02 POS?

  6. Karla says:

    if the doctor is in his house use home if he is in the office use POS 11 and GT modifier

  7. Lois Bernard says:

    I have the same question. I was told use POS 11 modifier 95

  8. Renee Dustman says:

    Karla: This is incorrect, for Medicare, at least. The doctor should use his billing POS. Unless the provider temporarily changed their POS to their residence, you would not bill “home.” Modifier GT is only required in for critical access hospitals.

  9. Renee Dustman says:

    Lois, That is correct for services provided via telehealth that normally would be conducted in the physician office.

  10. Renee Dustman says:

    Michele: It depends on the payer.

  11. Renee Dustman says:

    Ellen: For the most part, commercial plans follow Medicare policy, but you should confirm with the payer.

  12. Renee Dustman says:

    Please see our more recent posts on telehealth coding during the PHE for COVID-19.