When to Use CPT Modifier -93

Question:

In 2022, the question was, “should we begin using the new CPT® modifier -93?” Now, the question is, when should we use it?

Answer:

When I first answered this question in 2022, I recommended a wait and see approach.  But, we aren’t waiting any longer.

Modifier -93 Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System: Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.

• Use modifier -93 on telehealth services that are audio-only
• CMS has a specific HCPCS modifier FQ  for audio only for behavioral health services performed via telehealth, after 1-1-2022.
• Use modifier -95 on telehealth services that use real time, audio visual communication.

And, see our longer article about the topic, linked below.

Modifier 95, 93: Telemedicine