The primary modifier for telehealth is modifier 95, which indicates a service delivered through real-time, interactive audio and video. Medicare requires modifier 95 on all telehealth claims, and most commercial payers accept it as well. However, it’s not the only modifier involved in telehealth billing. Depending on the payer, the type of technology used, and where the patient is located, you may need a different modifier or a combination of codes.
Modifier 95: The Standard Telehealth Modifier
Modifier 95 means the service was a synchronous telemedicine visit rendered through a real-time interactive audio and video system. “Synchronous” simply means both the provider and the patient were communicating live, not through stored messages or pre-recorded video. This is the modifier Medicare currently requires on all professional telehealth claims.
You append modifier 95 to the same CPT or HCPCS procedure code you would use for an in-person visit. For example, if you bill a standard office visit code, adding modifier 95 tells the payer that visit happened over video instead of in the exam room. The underlying service code stays the same.
GT and GQ: Older Modifiers Still in Use
Before modifier 95 became the standard, two other modifiers were common:
- GT: Indicates a service rendered via interactive audio and video telecommunications. Medicare no longer requires GT for professional telehealth claims, but many private payers still accept it.
- GQ: Indicates a service rendered via an asynchronous (store-and-forward) telecommunications system. This applies when the provider reviews patient data, images, or video that were recorded and transmitted earlier, rather than conducting a live visit.
Some commercial insurers, including Cigna, accept modifier 95, GT, or GQ interchangeably and only require that one of the three is present on the claim. The specific modifier used does not change reimbursement with these payers. That said, always verify with each payer, because requirements vary and using the wrong modifier is a common reason for claim denials.
Audio-Only Modifiers: 93 and FQ
Not every telehealth visit uses video. When a visit is conducted by phone only, modifier 93 indicates the service was delivered via audio-only technology. Modifier FQ serves a similar purpose for certain Medicare services. These modifiers distinguish a phone-based clinical visit from a standard video telehealth encounter.
Not all payers recognize audio-only modifiers. Cigna, for instance, specifically asks providers not to bill with modifiers 93 or FQ at this time. Medicare has its own rules about which services qualify for audio-only delivery. If you’re billing audio-only visits, check the payer’s current policy before submitting claims.
Place of Service Codes Work Alongside Modifiers
Telehealth billing requires more than just a modifier. You also need the correct Place of Service (POS) code, and this choice directly affects how much you get reimbursed.
- POS 02: The patient received the telehealth service somewhere other than their home, such as a clinic, hospital, or skilled nursing facility.
- POS 10: The patient received the telehealth service in their home.
POS 02 typically reimburses at the facility rate, while POS 10 reimburses at the non-facility rate, which is generally higher. Getting this wrong can mean leaving money on the table or triggering an audit. The modifier tells the payer the visit was virtual; the POS code tells them where the patient was sitting during that visit.
Originating Site Facility Fees
When a patient goes to a healthcare facility to receive a telehealth visit (rather than connecting from home), that facility can bill a separate originating site fee using HCPCS code Q3014. For 2026, Medicare pays 80% of the lesser of the actual charge or $31.85 for this fee. The patient is responsible for any remaining coinsurance and unmet deductible. This fee compensates the facility for providing the room, equipment, and connectivity the patient uses during the visit.
Current Medicare Telehealth Flexibilities
Several pandemic-era telehealth expansions remain in effect through the end of 2027. Through December 31, 2027, Medicare beneficiaries can receive telehealth services from anywhere in the United States, with no requirement to be in a rural area or at a medical facility. Starting January 1, 2028, patients will generally need to be at a medical facility in a rural area to qualify for Medicare telehealth, with an exception for behavioral health services.
Rural Health Clinics and Federally Qualified Health Centers can continue serving as distant sites for telehealth through 2027, billing non-behavioral health telehealth services with HCPCS code G2025. Behavioral health telehealth services at these facilities are paid under their standard reimbursement systems. As of 2026, Medicare also permanently removed frequency limits on telehealth for subsequent inpatient visits, nursing facility visits, and critical care consultations.
How to Choose the Right Modifier
For most providers billing Medicare in 2025 or 2026, the process is straightforward: use modifier 95 with the appropriate procedure code and the correct POS code (02 or 10). If the visit was audio-only and the service qualifies, use modifier 93 or FQ per Medicare guidelines.
For commercial payers, the picture is less uniform. Some accept only modifier 95, others still want GT, and some accept any of the three synchronous modifiers. A few payers have their own proprietary requirements entirely. The safest approach is to check each payer’s current telehealth billing guide before submitting claims, especially since these policies have changed frequently over the past several years and continue to evolve.