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Wiki Telehealth Billing on UB-04

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Bakersfield, CA
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Is it possible to bill telehealth services on a UB-04? For a solely virtual Community Mental Health Center (CMHC) providing IOP-Intensive Outpatient services with rev code 0905 and HCPCS code S9480 , how would we indicate the services are telehealth? It is my understanding that the place of service is driven by the bill type and there is not a bill type for telehealth services. Should a modifier be applied? Can a modifier be applied on a UB-04 form? If so, what modifier considering 95 is no longer required.
 
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