Modifier 95
Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system
✅ When to Use Modifier 95
Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system
⛔ When NOT to Use Modifier 95
Some payers use POS codes instead of modifier 95. Check payer requirements.
📋 Documentation Requirements
Document that visit was conducted via live video.
Coding Tips for Modifier 95
Real-world specialist guidance from the PayerReady Medical Coding Team, including audit triggers, denial patterns, and payer policy variations.
Synchronous telehealth via real-time interactive audio and video. Code as the in-person CPT plus modifier 95. Place of Service must be 02 (telehealth other) or 10 (telehealth in patient home) per 2026 CMS rules. Audio-only encounters use modifier 93 instead.
Modifier 95 FAQ
What does modifier 95 mean? +
Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system
When should I use modifier 95? +
Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system
When should I NOT use modifier 95? +
Some payers use POS codes instead of modifier 95. Check payer requirements.
What documentation is required for modifier 95? +
Document that visit was conducted via live video.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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