Modifier 95- Synchronous Telemedicine Service Rendered Via Real-Time Interactive Audio and Video Telecommunications System

Modifier 95 is used to identify eligible telemedicine services provided through real-time interactive audio and video communication.

What is Modifier 95?

Modifier 95 identifies telemedicine services furnished through real-time interactive audio and video telecommunications between the provider and the patient. It is reported when an eligible healthcare service is delivered remotely using live two-way communication and payer requirements permit telehealth billing. Modifier 95 distinguishes audio-video telemedicine services from in-person visits and audio-only encounters.

When to Use Modifier 95

• An eligible telemedicine service is provided using live audio and video.

• The provider and patient communicate in real time.

• The reported service qualifies for telehealth billing.

• Payer guidelines permit the use of Modifier 95.

Billing Example

A physician conducts a follow-up visit with an established patient using a secure video conferencing platform. Because the encounter is performed through real-time audio and video communication, Modifier 95 is appended to the eligible service.

Documentation Tips

• Document that the encounter used real-time audio and video.

• Record the date and duration of the telemedicine service.

• Include the patient's assessment, diagnosis, and treatment plan.

• Verify payer-specific telehealth billing requirements.

Common Denial Reasons

• The service is not eligible for Modifier 95.

• Documentation does not support an audio-video encounter.

• Payer does not recognize Modifier 95.

• Required telehealth documentation is incomplete.

Related Modifiers

Modifier 93

Modifier GT

Modifier GQ

Home > All Modifiers > Telehealth Modifiers > Modifier 95