New modifier for audio-only telehealth in 2022

Earlier this year the CPT Editorial Panel accepted the addition of modifier 93 for audio-only telehealth, effective Jan. 1, 2022. CPT labels modifier 93 as “Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system.” The full description is:

Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.

Although this modifier takes effect the first day of 2022, it won’t appear in the CPT manual until 2023. There has been no indication yet of how Medicare or other payers will handle the new modifier.

— Kent Moore, senior strategist for physician payment, American Academy of Family Physicians

Posted on Dec. 29, 2021, by Kent Moore