Reimbursement Rates For Telehealth
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FAQ
For Medi-Cal, the modifiers for telehealth are as follows: Synchronous, Interacfive Audio and Telecommunicafion Systems: Modifier 95 Modifier 95 must be used for Medi-Cal covered benefits or services delivered via synchronous, interactive audio/visual telecommunications systems.
There is much overlap between the use of GT and 95 modifiers, but 95 is commonly used for psychiatric, nutrition, and genetic services, among others. Modifier 95 is like GT in use cases, but unlike GT there are limits to the codes that it can be appended.
The GT modifier is a coding modifier used for Telehealth claims. For many years it was the standard for signifying Telehealth claims before being mainly supplanted by the 95 modifier.
HCPCS Code Q3014 describes the Medicare telehealth originating sites facility fee. Bill your MAC for the separately billable Part B originating site facility fee. The payment amount for HCPCS code Q3014 (Telehealth originating site facility fee) is 80% of the lesser of the actual charge ($28.64 for CY 2023 services).
? For 2023, continue billing telehealth claims with the POS indicator you'd bill for an in-person visit. You must use Modifier 95 to identify them as telehealth through December 31, 2023.