We have had multiple requests for a “Quick & Easy” Telemedicine services billing and modifier guide. Remember that all services require the patient’s verbal consent (noted in patent chart).
Telemedicine Modifiers Guide:
Telehealth Visit – Audio Video
POS 02 / 99201-99299
| Payable | Modifier | |
|---|---|---|
| AETNA BETTER HEALTH | YES | GT/95 |
| AETNA HEALTHCARE | YES | GT/95 |
| AVMED | 99201-15 | 95 |
| Avmed Medicare Advantage | YES | 95 |
| Careplus | YES | 95 |
| DOCTORS HEALTH | YES | GT |
| FLORIDA BLUE | 99201-15 | 95/GT |
| HEALTHSUN | YES | |
| HUMANA | 99201-15 | 95 |
| MEDICAID | YES | GT |
| Medicare and Much More | YES | 95 |
| MOLINA MDC HMO | 99201-15 | NO |
| NCH-CarePlus (do POS you normally use) | 99211-99212 | 95 |
| NCH-Devoted Health (do POS you normally use) | 99211-99212 | 95 |
| NCH-Simply (Cardiology) (do POS you normally use) | 99211-99212 | 95 |
| NCH-Vista (do POS you normally use) | 99211-99212 | 95 |
| Positive HealthCare | 99201-15 | |
| SIMPLY MCR | YES | 95 |
| SIMPLY MCD | YES | GT |
| Sunshine Allwell | YES | GT |
| SUNSHINE ambetter | YES | GT |
| Sunshine Medicaid | YES | GT |
| Solis HealthPlan | YES | |
| Tricare East | YES | |
| UHC AARP | YES | 95 |
| UHC Medica | YES | 95/GT |
| UHC Preferred by AMWELL (app) | YES | 95/GT |
| WELLCARE | 99201-15 | 95 |
| WELLMED only by AMWELL (app) | 99201-99292 |
Telehealth Visit – Audio Video
POS 11 / 99201-99299
| Payable | Modifier | |
|---|---|---|
| BCBS MCR Advantage (POS you normally use) | 99201-15 | 95/GT |
| CIGNA (POS you normally use) | YES | 95/GT |
| MEDICARE (POS you normally use) | YES | 95 |
| UHC Medicaid (POS you normally use) | YES | 95/GT/GQ/G0 |
| UHC MCR advantage plan (POS you normally use) | YES | 95 |
| UHC (POS you normally use) | YES | 95 |
Telemedicine Modifier Guide:
Telehealth Visit – Telephone only
POS 02 / 99441 – 99443
| Payable | Modifier | |
|---|---|---|
| AETNA BETTER HEALTH | YES | CR |
| AETNA HEALTHCARE | YES | NO |
| AVMED | NO | |
| Avmed Medicare Advantage | NO | |
| Careplus | YES | NO |
| DOCTORS HEALTH | NO | |
| FLORIDA BLUE | YES | |
| HEALTHSUN | NO | |
| HUMANA | YES | NO |
| MEDICAID | YES | CR |
| Medicare and Much More | YES | NO |
| MOLINA MDC HMO | YES | NO |
| NCH-CarePlus (do POS you normally use) | YES | |
| NCH-Devoted Health (do POS you normally use) | YES | |
| NCH-Simply (Cardiology) (do POS you normally use) | YES | |
| NCH-Vista (do POS you normally use) | YES | |
| Positive HealthCare | NO | |
| SIMPLY MCR | YES | NO |
| SIMPLY MCD | NO | NO |
| Sunshine Allwell | YES | 95 |
| SUNSHINE ambetter | YES | NO |
| Sunshine Medicaid | YES | GT |
| Solis HealthPlan | NO | NO |
| Tricare East | NO | |
| UHC AARP | NO | |
| UHC Medica | YES | |
| UHC Preferred by AMWELL (app) | YES | |
| WELLCARE | NO | |
| WELLMED only by AMWELL (app) | YES |
Telehealth Visit – Telephone only
POS 11 / 99441 – 99443
| Payable | Modifier | |
|---|---|---|
| BCBS MCR Advantage (POS you normally use) | YES | |
| CIGNA (POS you normally use) | YES | |
| MEDICARE (POS you normally use) | YES | NO |
| UHC Medicaid (POS you normally use) | NO | |
| UHC MCR advantage plan (POS you normally use) | NO | |
| UHC (POS you normally use) | NO |
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