Modifier 95
CPT modifier indicating a synchronous telemedicine service rendered via real-time interactive audio and video.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Telehealth
- Primary sources
- 2
- Workspace handoff
- ask d3 →
Where this comes up
Telehealth coding, place-of-service, modifier (95, GT, GQ, FQ, FR), and post-PHE policy parity all converge here. State licensure rules and DEA controlled-substance prescribing rules add a second compliance layer most billers learn about only after the first denial.
Full definition
What it is in practice
CMS and the AMA recognize modifier 95 for synchronous telehealth. Commercial payers vary on whether they require 95 or 93 (audio-only) — confirm payer-specific policy.
How it shows up in your practice
Build modifier 95 into telehealth charge templates. Modifier choice often determines whether the claim pays at parity with in-person.
Sources
- CMS — Medicare Telehealth Services Listhttps://www.cms.gov/medicare/coverage/telehealth/list-services
- CMS — Modifiershttps://www.cms.gov/medicare/coding-billing/modifiers
Confirm telehealth modifier rules in Ask D3
Open ask d3 →Related terms
- TelehealthTelehealthDelivery of health care services through audio-video or audio-only technology when the patient is not at the same location as the practitioner.
- TelehealthAudio-Only TelehealthTelehealth services delivered via telephone or other audio-only technology, without a video component.
- TelehealthTelehealth POS Codes (02 and 10)Place of Service 02 (telehealth other than home) and POS 10 (telehealth in patient's home) identify telehealth encounters on professional claims.
- TelehealthModifier 93 (Audio-Only Synchronous Telehealth)CPT modifier indicating a synchronous telemedicine service rendered via audio-only technology.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryAudio-Only TelehealthTelehealth services delivered via telephone or other audio-only technology, without a video component.
- GlossaryModifier 93 (Audio-Only Synchronous Telehealth)CPT modifier indicating a synchronous telemedicine service rendered via audio-only technology.
- GlossaryTelehealthDelivery of health care services through audio-video or audio-only technology when the patient is not at the same location as the practitioner.
- GlossaryTelehealth POS Codes (02 and 10)Place of Service 02 (telehealth other than home) and POS 10 (telehealth in patient's home) identify telehealth encounters on professional claims.
- GlossaryModifier 22CPT modifier indicating increased procedural services requiring substantially greater work than usually required.
- GlossaryModifier 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
- GlossaryModifier 26CPT modifier indicating the professional component of a procedure.
- RegulationMLN: Medicare Telehealth ServicesReference to Medicare's telehealth policy: covered services list, originating and distant site rules, technology requirements, and the COVID-era flexibilities and their post-PHE status.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.