Modifier GT- Interactive Audio and Video Telehealth

Modifier GT identifies qualifying telehealth services furnished through interactive audio and video telecommunications.

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What is Modifier GT?

Modifier GT identifies a service furnished through an interactive audio and video telecommunications system.

Historically, Medicare used GT broadly for professional telehealth claims. That changed in 2018 when CMS eliminated the GT requirement for most professional telehealth claims and moved to place-of-service reporting.

However, Modifier GT remains relevant under Medicare for a specific billing circumstance. Current CMS guidance states that distant-site practitioners billing telehealth through a Critical Access Hospital (CAH) using optional Method II must report GT on the institutional claim.

Because of this limited use, providers should not treat GT as the standard Medicare telehealth modifier for every audio-video encounter.

When to Use Modifier GT

CAH Method II Billing: The telehealth service is billed by a Critical Access Hospital that elected Method II.

Distant-Site Service: The practitioner furnishes the qualifying Medicare telehealth service from the distant site.

Interactive Audio and Video: The service is furnished using applicable real-time telecommunications technology.

Institutional Claim: The CAH reports the professional service through the applicable institutional billing process.

Reassigned Billing Rights: The practitioner has reassigned applicable billing rights to the Method II CAH.

When NOT to Use Modifier GT

Standard Medicare Professional Claim: Medicare eliminated GT from ordinary professional telehealth claims beginning in 2018.

Audio-Only Service: GT describes interactive audio-and-video telecommunications and should not be used simply to identify an audio-only encounter.

Asynchronous Demonstration Service: Applicable asynchronous telehealth under the federal Alaska or Hawaii demonstration uses Modifier GQ rather than GT.

Non-Telehealth Service: Do not append GT when the service was furnished entirely in person.

To Establish Coverage: GT does not make an otherwise noncovered service eligible for Medicare payment.

Billing Example

A physician provides an eligible Medicare telehealth service to a beneficiary using real-time interactive audio and video.

The physician has reassigned billing rights to a Critical Access Hospital that elected Method II billing.

The CAH submits the qualifying distant-site professional service on its institutional claim and appends Modifier GT according to Medicare requirements.

GT communicates that the service was furnished through interactive audio-video telecommunications under the applicable CAH Method II telehealth billing rules.

Documentation Requirements

Telehealth Modality: Document that the encounter was furnished using the applicable telecommunications technology.

Service Provided: Document the clinical service actually furnished during the encounter.

Medical Necessity: The record should support why the underlying service was reasonable and necessary.

Patient Information: Maintain the beneficiary information required for the encounter and claim.

Practitioner Information: Identify the distant-site practitioner furnishing the professional service.

CAH Billing Arrangement: Billing records should support the applicable Method II arrangement and reassignment of billing rights.

Procedure Code: Documentation must support the CPT or HCPCS code reported.

Billing and Claim Considerations

The most important issue with Modifier GT is understanding its limited modern Medicare role.

CMS eliminated GT from standard Medicare professional telehealth claims effective in 2018. Current professional telehealth billing generally relies on the appropriate procedure code, place of service, and other applicable telehealth reporting requirements rather than GT.

GT nevertheless remains required for qualifying distant-site telehealth services billed through a CAH under Method II on institutional claims. CMS's current 2026 telehealth guidance specifically retains this requirement.

Providers should therefore avoid automatically adding GT to every Medicare telehealth service based on older billing guidance.

Commercial payer requirements can differ from Medicare. A payer may maintain its own GT policies, making payer-specific verification important before claim submission.

Common Billing Mistakes

Using GT on All Medicare Telehealth Claims: GT is no longer generally required on Medicare professional claims.

Following Outdated Guidance: Older resources may describe GT as the standard Medicare audio-video telehealth modifier.

Using GT for Audio-Only Care: GT specifically identifies interactive audio-and-video telecommunications.

Confusing GT With GQ: GQ applies to qualifying asynchronous telehealth under specific federal demonstration circumstances.

Ignoring CAH Method II Requirements: Medicare's continuing GT requirement applies specifically to qualifying Method II CAH institutional billing.

Assuming All Payers Follow Medicare: Commercial payer requirements for GT may differ.

Common Denial Reasons

Incorrect Claim Type: GT is submitted on a Medicare claim where current billing rules do not permit or require it.

CAH Method II Requirements Are Not Met: The billing arrangement does not qualify for the Medicare GT exception.

Service Is Not Telehealth Eligible: The underlying service does not satisfy applicable telehealth coverage requirements.

Incorrect Modifier: Another telehealth reporting method or modifier better represents the service.

Documentation Is Insufficient: The medical record does not support the service, modality, or medical necessity.

Billing Rights Are Not Properly Reassigned: The applicable practitioner-to-CAH billing arrangement is not established.

Modifier GT vs. Modifier GQ

Modifier GT: Interactive audio-video telehealth; under current Medicare rules, retained for qualifying CAH Method II institutional claims.

Modifier GQ: Asynchronous telecommunications service under applicable federal telemedicine demonstration requirements in Alaska or Hawaii.

The modifiers describe different telehealth modalities and should not be used interchangeably.

Frequently Asked Questions

Is Modifier GT still active for Medicare?
Yes, but its use is limited. Current CMS guidance retains GT for qualifying distant-site telehealth services billed on institutional claims by Method II Critical Access Hospitals.

Should Modifier GT be added to every Medicare video visit?
No. CMS eliminated GT from ordinary Medicare professional telehealth claims beginning in 2018.

Related Modifiers

Modifier GQ: Identifies qualifying asynchronous telecommunications services.

Modifier 95: Identifies synchronous telemedicine services under applicable payer requirements.

Modifier 93: Identifies applicable synchronous telemedicine services rendered via telephone or other real-time interactive audio-only telecommunications.