95: Telehealth via synchronous audio and video
Modifier 95 tells the payer the service was delivered by real-time audio and video. It is appended to the CPT code (for example 90834-95). Some payers prefer modifier GT or rely on the place-of-service code alone; the payer decides, and Emora applies the right one.
- Kind
- Modifier
- Family
- telehealth
- Time
- Appended to the service code
- Who bills
- Therapists, Psychologists, Nurse practitioners, Associates
- Telehealth
- Eligible
- Add-on
- Stands alone
When to use it
On every synchronous video session for payers that require it. Pair it with the correct place-of-service code (10 for the client at home, 02 for other locations).
When not to
Not for audio-only visits, which use modifier 93 where the payer allows audio-only at all. Not for messaging or asynchronous check-ins.
With children and families
Children join from home, sometimes from school or a car with a parent. Record where the child was; that drives the place-of-service code, and some payers restrict certain locations. Emora's platform captures the modality; you document the location.
Questions about 95
- Do I add modifier 95 myself?
- No. You document the modality and location; Emora applies the modifier the payer wants.
- What about audio-only sessions?
- Modifier 93 where allowed; many payers limit audio-only for children. Note why video was not possible.
Related
| Code | What it is | Time | Who bills | Telehealth |
|---|---|---|---|---|
| 10 | Place of service 10: telehealth in the patient's home | Claim-level place of service | Therapists, Psychologists, Nurse practitioners, Associates | Yes |
General information for licensed clinicians, not billing advice. Insurers reimburse each code differently and payer contracts control; Emora handles the billing.
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