Wiki Covid 19 Mod GT/95

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jsilvestri77@comcast.net

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I'm having trouble with the difference between Mod GT and Mod 95. Does anyone have any clarification on these mods?
 
GT MODIFIER:

  • The GT modifier is used to indicate a service was rendered via synchronous telecommunication.
  • In 2018, CMS replaced the GT modifier with POS 02. However, this does not mean that the GT modifier is no longer recognized. Some private payers still recognize and prefer the GT modifier. The Rules Engine provides modifier recommendations for each appointment based on past claims data to help providers determine which modifier is most appropriate.
MODIFIER 95:

  • Modifier 95 is a fairly new modifier and used only when billing to private payers to indicate services were rendered via synchronous telecommunication.
  • It is important to note that Medicare and Medicaid do not recognize modifier 95. As with the GT modifier, not all payers recognize modifier 95. The rules engine is a good resource when it comes to selecting a modifier for your claim.
PLACE OF SERVICE 02:

  • According to CMS, POS 02 is defined as “the location where health services and health-related services are provided or received, through a telecommunication system.”
  • CMS has replaced the GT modifier with POS 02. POS 02 can be used when billing CMS claims for synchronous telemedicine visits
But how do you know when to use each code? The only way to find out is to call the payer to find out their policy for telemedicine visits. If you’ve ever called an insurance company you know this is a labor intensive process. Fortunately Chiron Health has built a scalable, automated database that takes into account the variations between payers and the rapidly changing nature of telemedicine reimbursement policies.
 
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