What is the difference between modifier GT and modifier 95?

Both signal synchronous telehealth, but 95 has largely replaced GT. Modifier 95 (synchronous audio-video) is the current CPT standard that most payers expect. Modifier GT is a legacy HCPCS telehealth modifier that Medicare retired for most claims years ago in favor of 95 plus the telehealth place-of-service code. GT survives mainly for Critical Access Hospitals billing under Method II, and with a handful of commercial and Medicaid plans that still require it — so it is payer-specific, not a default.

When do I use modifier 93 instead of 95?

Modifier 95 is for real-time audio-video visits. Modifier 93 is for real-time audio-only visits — a telephone encounter with no video. Use 93 only when the service is one the payer allows to be delivered audio-only, and document why video was not used. Coverage for audio-only is narrower than for audio-video and varies by payer.

Does Medicare require modifier 95 with POS 10?

Medicare fee-for-service does not require modifier 95 when telehealth is billed with POS 10 (patient at home); the place-of-service code carries the telehealth designation. However, most commercial payers do require modifier 95 on audio-video telehealth, so the safe default is to append it (or 93 for audio-only) unless a specific payer policy says otherwise.

Modifier FQ indicates a service furnished using audio-only communication technology for behavioral health, used by FQHCs and RHCs and in certain Medicare behavioral health contexts. It documents that a covered behavioral health service was delivered audio-only when video was unavailable or declined by the patient.

Coding guides

GT vs 95 & the Telehealth Modifiers That Still Trip People Up

Telehealth modifiers look simple until you notice Medicare and commercial payers want different things. GT is mostly gone, 95 is the default, 93 covers audio-only — and the place-of-service code, not the modifier, sets the payment. Here's the current map.

The telehealth modifiers in four facts

95 = A/V

Real-time audio-video — the default

93 = audio

Real-time audio-only, narrower coverage

GT retired

Legacy; mostly CAH Method II now

POS pays

POS 02/10 sets the rate, not the modifier

GT vs 95: the short history that explains the confusion

For years, Medicare telehealth claims used modifier GT ("via interactive audio and video telecommunications"). When CPT's modifier 95 arrived to describe the same synchronous audio-video service, Medicare moved off GT — telling providers to use 95 plus the telehealth place-of-service code instead. That's why 95 is now the default nearly everywhere and GT feels like a ghost.

But GT isn't fully dead. It still appears for Critical Access Hospitals billing under Method II, and a scattering of commercial and Medicaid plans that never updated their policies still ask for it. The practical rule: default to 95, but check the payer — using GT where a payer wants 95 (or the reverse) is a clean denial. This is exactly the kind of per-payer quirk worth tracking in your payer policy notes.

95 vs 93 vs FQ: modality, not location

These modifiers describe how the visit happened. 95 is real-time audio-video — the standard telehealth encounter. 93 is real-time audio-only: a phone visit with no video, allowed only for services a payer permits audio-only, with documentation of why video wasn't used. FQ flags audio-only behavioral health for FQHCs/RHCs and certain Medicare contexts. Behavioral and mental telehealth in the home is now a permanent Medicare benefit, which makes the audio-only behavioral modifiers more relevant, not less.

What these modifiers do not do is set the payment. That's the job of the place-of-service code — POS 10 (patient home) pays the higher non-facility rate, POS 02 (not home) the facility rate — covered in full on our place-of-service guide. Modality modifier plus correct POS is the combination that pays right.

Medicare vs commercial: the mismatch that causes denials

The single most common telehealth-modifier error isn't picking the wrong modifier — it's assuming every payer wants the same thing. Medicare fee-for-service does not require modifier 95 with POS 10 (the POS already signals telehealth), but most commercial payers do require 95 on audio-video claims. Strip 95 off for a commercial payer that wants it and the claim denies; the reverse is rarely penalized. So the safe operating default is: append 95 (or 93 for audio-only) on every telehealth claim unless a payer's published policy explicitly says to omit it.

And remember the coding pathway split: for Medicare, telehealth E/M is still 99202–99215 + POS + modifier — Medicare does not pay the new 98000-series telemedicine codes, while some commercial payers want them. That two-track reality lives in the POS guide too.

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POS 02 vs 10, every telehealth modifier, the Medicare-vs-commercial rules, and the flexibility dates — one printable page.

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Telehealth modifiers at a glance

Mod	Modality	Use it when
95	Synchronous audio-video	The default for real-time video telehealth; most commercial payers require it
93	Synchronous audio-only	Phone visit, no video, for services the payer allows audio-only
GT	Legacy audio-video	Only where still required — mainly CAH Method II and some commercial/Medicaid plans
FQ	Audio-only behavioral health	FQHC/RHC and certain Medicare behavioral health, delivered audio-only

Telehealth policy is payer-specific and changing through 2027 — verify against current Medicare and commercial payer guidance. See the place-of-service guide for the flexibility dates. CPT® is a registered trademark of the AMA.

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