Telemedicine modifier: CPT® Adds New Modifier 95 To Capture Synchronous Telemedicine Services

Why This Topic Matters

The update affects how telemedicine services are identified in CPT and how coders, billers, and compliance teams track which services may be reported with synchronous telehealth support. It is important for understanding the scope of CPT’s telemedicine guidance and how payer policy influences code selection.

Article Sections

1. Telemedicine reporting background and CPT decision

   Explains the long-running review of telemedicine reporting and the general direction taken in the 2017 CPT update. It provides context for the move toward a modifier-based approach.

2. New telemedicine modifier and reporting concept

   Describes the introduction of a new CPT modifier for synchronous telemedicine and the general reporting framework associated with real-time audio and video services. It also notes the broader discussion of alternative approaches considered by the editorial panel.

3. Appendix P and code categories included

   Summarizes the new CPT appendix that identifies categories of services associated with synchronous telemedicine reporting. It indicates the appendix’s role in guiding attention to eligible code families without listing coding details.

4. Emergency medicine and payer-policy context

   Addresses the article’s discussion of emergency medicine, the relationship to payer policy, and why certain service categories were not included. It highlights the practical implications for specialty-specific reporting.