CPT modifier
Modifier 95: Synchronous telemedicine (audio and video)
Modifier 95 is a CPT modifier. In plain terms: The service was delivered through real-time, interactive audio and video.
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- Modifier
- 95
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- The service was delivered through real-time, interactive audio and video.
- How it is used
- Medicare telehealth claims also need the place of service code for where the patient was (02 or 10). Check payer rules.
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
- Guidance
- CMS Medicare telehealth page
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
Related modifiers
- 93Audio-only telemedicine
- GTVia interactive audio and video telecommunication systems
- GQVia asynchronous telecommunications system
- FQThe service was furnished using audio-only communication technology
- FRThe supervising practitioner was present through two-way, audio/video communication technology
- 96Habilitative services
- 97Rehabilitative services
- 92Alternative laboratory platform testing
Related pages
- All CPT and HCPCS modifiersA to Z list
- CMS-1500 claim formModifiers go in item 24D
- Denial code CO-4Modifier missing or does not fit the code
- Denial code CO-182Modifier invalid on the date of service
- Place of service 02Telehealth outside the patient's home
- Place of service 10Telehealth in the patient's home
- HCPCS Level II code lookup
- Denial and remark codes
Questions
What does modifier 95 mean?
Modifier 95 is a CPT modifier. In plain terms: The service was delivered through real-time, interactive audio and video.
Is modifier 95 a CPT or a HCPCS modifier?
95 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 95 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 95 used?
Medicare telehealth claims also need the place of service code for where the patient was (02 or 10). Check payer rules.
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.