Telehealth Billing and Coding Basics

There are two telehealth-specific places of service (POS):

• POS 02 is used for telehealth services provided in a location other than the patient’s home. 
• POS 10 is used for telehealth services provided to a patient located in their home. 

A home is considered a location other than a hospital or other facility where the patient receives care in a private residence. 

Payers are gradually transitioning from their temporary COVID-19 policies to permanent telehealth policies. Review the AAFP’s telehealth coding scenarios and check with your local provider relations representatives for information regarding which POS they require. 

What are the different telehealth modifiers?

There are several modifiers that may be appended to telehealth services. The modifier may depend on the type of service. 

• -95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.

• -93: Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system.

• -GQ: Telehealth service rendered via asynchronous telecommunications system.

• -GT: Telehealth service rendered via interactive audio and video telecommunications systems

• -FQ: A telehealth service was furnished using real-time audio-only communication technology.

Medicare no longer uses the GT modifier for professional services. However, many private payers still accept it.

Review the AAFP’s telehealth coding scenarios and check with your local provider relations representatives for information regarding which modifiers they require. 

What services can I provide via telehealth?

The Medicare list of approved telehealth services is available as a zipped file, which also includes the list of services that Medicare will allow via audio-only communications technology. 

Contact your local provider relations representatives for their lists of approved telehealth services. 

Can I provide the annual wellness visit via telehealth?

The annual wellness visit (AWV) is on Medicare’s list of approved telehealth services. Medicare will also allow the AWV to be completed using audio-only communications technology.

Medicare states that self-reported vitals may be used when a beneficiary is at home and has access to the types of equipment they would need to self-report vitals. The visit must also meet all other requirements.

Note: the Initial Preventive Physical Exam (IPPE) is not on Medicare’s list of approved telehealth services.