Modifier 93- Synchronous Audio-Only Telemedicine

Identifies a synchronous telemedicine service provided through telephone or another real-time interactive audio-only telecommunications system.

What Is Modifier 93?

Modifier 93 identifies a healthcare service furnished using real-time, interactive audio-only telecommunications technology.

Unlike Modifier 95, which identifies synchronous telemedicine using real-time audio and video, Modifier 93 communicates that the qualifying service was provided through audio-only communication.

CMS continues to recognize Modifier 93 in 2026. Current Medicare guidance uses it for qualifying audio-only services, including certain telehealth, RHC/FQHC, and opioid treatment program services.

When to Use Modifier 93

Audio-Only Communication: The patient and practitioner communicate through real-time interactive audio technology without video.

Synchronous Service: Communication occurs live rather than through recorded messages, email, or other asynchronous technology.

Qualifying Service: The underlying service is eligible to be furnished using audio-only technology under the applicable Medicare or payer policy.

Medicare Requirements Met: The service satisfies any patient-location, technology, consent, provider, or service-specific requirements that apply.

Required Claim Identification: Modifier 93 is appended when Medicare or another payer requires the claim to identify the service as audio-only.

When NOT to Use Modifier 93

Audio and Video Used: Modifier 95 generally identifies qualifying synchronous services furnished through real-time interactive audio and video.

Asynchronous Communication: Modifier 93 does not describe store-and-forward or other asynchronous communications.

Service Requires Video: Do not use Modifier 93 when applicable coverage or coding rules require an audio-video telecommunications system.

Telephone Contact Alone: A telephone conversation does not automatically qualify for Modifier 93. The underlying service must be eligible for audio-only reporting.

In-Person Service: Do not append Modifier 93 when the patient and practitioner are physically together for the reported service.

Billing Example

A practitioner furnishes a Medicare-covered service to an eligible patient through a real-time telephone connection.

The applicable Medicare requirements permit the particular service to be furnished through audio-only telecommunications.

The practitioner reports the appropriate service code with Modifier 93 to indicate that the encounter occurred using synchronous audio-only technology.

The documentation should identify the communication method and support all requirements for the underlying service.

Documentation Requirements

Communication Method: Document that the encounter occurred through synchronous audio-only telecommunications.

Service Provided: Record the clinical service furnished during the encounter.

Medical Necessity: Support the medical necessity of the underlying service.

Patient Information: Document the patient and encounter information required for the reported service.

Technology Requirements: When applicable, document circumstances required by Medicare or the payer for use of audio-only technology.

Service-Specific Requirements: Maintain any additional documentation required for the particular CPT or HCPCS code reported.

Billing and Claim Considerations

Modifier 93 identifies the communication technology used, but it does not independently establish that a service qualifies for Medicare telehealth payment.

The underlying service must satisfy current Medicare coverage and billing requirements for audio-only delivery.

CMS currently uses Modifier 93 in several contexts. For example, Medicare instructs opioid treatment programs to append Modifier 93 to specified services furnished through audio-only technology.

CMS also announced that beginning October 1, 2026, RHCs and FQHCs reporting applicable distant-site telehealth services with individual CPT or HCPCS codes use Modifier 93 for audio-only services and Modifier 95 for audio-video services.

Because Medicare telehealth policies can vary by service and setting, providers should verify that the specific service qualifies for audio-only delivery rather than assuming Modifier 93 makes the service payable.

Common Billing Mistakes

Confusing 93 With 95: Modifier 93 identifies audio-only communication; Modifier 95 identifies synchronous audio-video communication.

Assuming Every Telephone Call Qualifies: The underlying service must meet applicable coverage and billing requirements.

Ignoring Service Eligibility: Not every service that can clinically be performed by telephone necessarily qualifies for Medicare audio-only payment.

Using 93 for Asynchronous Services: Modifier 93 specifically identifies synchronous, real-time communication.

Incorrect Underlying Code: The reported CPT or HCPCS code must accurately represent the service furnished.

Insufficient Documentation: The record does not establish that the service was furnished using qualifying audio-only technology.

Common Denial Reasons

Service Not Eligible for Audio-Only Delivery: Medicare or the payer does not permit the reported service through audio-only technology.

Incorrect Modifier: Modifier 95 or another telehealth reporting method better describes the service.

Coverage Requirements Not Met: The encounter fails to satisfy applicable Medicare telehealth requirements.

Documentation Insufficient: The record does not establish the communication method or service performed.

Incorrect Procedure Code: The underlying CPT or HCPCS code does not correspond to the documented service.

Payer-Specific Requirements: The claim does not comply with the payer's audio-only telehealth rules.

Modifier 93 vs. Modifier 95

Modifier 93: Synchronous telemedicine service provided through telephone or another real-time interactive audio-only telecommunications system.

Modifier 95: Synchronous telemedicine service provided through a real-time interactive audio and video telecommunications system.

The primary distinction is straightforward: Modifier 93 is audio-only, while Modifier 95 is audio and video. CMS continues to distinguish the two modifiers this way in current 2026 guidance.

Frequently Asked Questions

Is Modifier 93 still active in 2026?
Yes. CMS continues to recognize and use Modifier 93 for qualifying synchronous audio-only services in 2026.

Can Modifier 93 be used for any telephone visit?
No. Modifier 93 identifies the audio-only communication method, but the underlying service must independently qualify for reporting and payment through audio-only technology.