Medicare Compliance & Reimbursement

Last year, CMS eliminated modifier GT (Via interactive audio and video telecommunication systems) for all professional claims and outlined this change in the Medicare Physician Fee Schedule (MPFS) for CY 2018.

Now: On September 6, 2018, a new MLN Matters release, MM10583, Change Request (CR) 10583, updated the previous information about modifier GT (Via interactive audio and video telecommunication systems). The revision corrects the effective date of modifier GT. So, as of October 1, 2018 modifier GT is only allowed on institutional claims billed by a Critical Access Hospital (CAH) Method II.

Before this change, providers submitted claims for telehealth using the appropriate CPT^® code along with modifier GT. Then, CMS dropped the modifier requirement and now requires you to append (POS) code 02 (Telehealth) to describe services furnished via telehealth.

Bottom line: Only Critical Access Hospitals (CAHs) Method II should append modifier GT on institutional claims.