CPT modifier

Modifier 93: Audio-only telemedicine

Modifier 93 is a CPT modifier. In plain terms: The service was delivered through a real-time, audio-only call.

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Modifier
93
Type
CPT (Level I) modifier, maintained by the AMA
Plain description
The service was delivered through a real-time, audio-only call.
How it is used
Medicare also uses Level II modifier FQ for audio-only services. Check payer rules for which one applies.
Claim form
CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.

The CPT descriptor is AMA copyright and is not shown here. The description above is written by Rivvi. Read the CMS guidance linked above for Medicare's rules.

Telehealth

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Questions

What does modifier 93 mean?

Modifier 93 is a CPT modifier. In plain terms: The service was delivered through a real-time, audio-only call.

Is modifier 93 a CPT or a HCPCS modifier?

93 is a CPT (Level I) modifier. The AMA maintains CPT modifiers. Two-character codes with a letter, such as GT or XU, are HCPCS Level II modifiers from CMS.

Where does modifier 93 go on a claim?

On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.

When is modifier 93 used?

Medicare also uses Level II modifier FQ for audio-only services. Check payer rules for which one applies.

What denial comes back when a modifier is wrong?

A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.

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