Guide
Telehealth Billing Modifiers for Behavioral Health: 95, 93, GT, and POS 02 vs. 10
Modifiers 95, 93, and GT, plus the POS 02 vs. 10 distinction that quietly underpays telehealth claims.
Telehealth Coding
The Small Codes That Decide Whether Your Telehealth Visits Get Paid
For behavioral health practices, telehealth is no longer a pandemic workaround — it is core to how clinicians deliver care. But the billing rules behind a video or phone session are deceptively fiddly. A single missing modifier or the wrong place-of-service code can turn a clean claim into a denial, an underpayment, or a slow-pay headache. The codes themselves haven’t gotten simpler over time; if anything, the 2022 split of telehealth place-of-service codes and ongoing changes to Medicare’s telehealth list have given practices more ways to get it subtly wrong.
This guide walks through the modifiers that matter most for behavioral health telehealth — 95, 93, and the legacy GT — alongside the place-of-service choice between POS 02 and POS 10. The goal is to help you understand what each code signals to a payer and where the common, money-losing mistakes hide. As always with billing, the specifics shift constantly and vary by payer and state, so treat this as orientation rather than a payer-by-payer rulebook.
The Modifiers
95, 93, and GT: What Each One Tells the Payer
Modifiers are the two-character flags appended to a CPT code that tell the payer how a service was delivered. For telehealth behavioral health, three come up again and again. Getting them right is the difference between a claim that adjudicates cleanly and one that bounces back for “invalid modifier” or, worse, pays at the wrong rate.
Modifier 95 — Synchronous Audio-Video
This is the workhorse for live video sessions. Modifier 95 signals a synchronous, real-time encounter delivered over interactive audio and video. For the vast majority of commercial telehealth therapy and psychiatry visits conducted by video, 95 is the modifier you will reach for most.
Modifier 93 — Audio-Only
Modifier 93 identifies audio-only (telephone) services. Behavioral health has retained more audio-only flexibility than most specialties, which matters for clients who can’t or won’t use video. But coverage varies significantly by payer, so confirm before you rely on it for a given plan.
Modifier GT — The Legacy Flag
GT was the original audio-video telehealth modifier. It has been largely replaced by 95, but a handful of payers and contracts still require it. Don’t assume it’s dead — check your specific payer’s current guidance before dropping it from a claim that previously needed it.
These descriptions are general. Individual payers publish their own modifier requirements and may accept, require, or reject a given modifier in ways that differ from the norm — and those policies change. Always verify against the payer’s current telehealth billing policy.
Place of Service
POS 02 vs. POS 10: The Split That Quietly Costs Practices Money
Until 2022, telehealth had a single place-of-service code: 02. Then it split into two, and the distinction turns on where the patient is located during the visit — not where the provider sits. This is one of the most common sources of telehealth underpayment in behavioral health, precisely because it’s easy to default everything to the old, familiar 02.
POS 10 — Patient at Home
Use POS 10 when the patient receives telehealth in their own home. For many payers, POS 10 maps to the non-facility rate — frequently the higher of the two reimbursement schedules. For home-based behavioral telehealth, this is often the correct and more favorable code.
POS 02 — Patient Elsewhere
POS 02 covers telehealth provided somewhere other than the patient’s home — for example, a clinic, a facility, or another location. It can reimburse at a different (often lower) rate than POS 10, which is exactly why defaulting every telehealth claim to 02 can systematically underpay you.
The practical takeaway: don’t let your EHR or billing template hard-code POS 02 for all telehealth. Because most behavioral health telehealth happens with the client at home, blindly billing 02 across the board can leave money on the table on a large share of your visits. Confirm how each of your payers maps these codes to their fee schedules. If you’re managing this inside a practice-management platform, our notes on SimplePractice billing cover where these settings tend to live and how default selections can trip you up.
Medicare
Medicare Plays by Its Own Telehealth Rules
Medicare does not simply mirror commercial payer conventions. It maintains its own list of covered telehealth services and its own set of telehealth modifiers, and that framework has been extended and revised repeatedly through a series of legislative and regulatory actions. What was true a year ago may not be true today.
One example relevant to behavioral health: Medicare uses modifier FQ to indicate that a behavioral health service was furnished audio-only. That’s distinct from the commercial-world modifier 93, which underscores the broader point — you cannot assume a modifier or place-of-service convention carries cleanly from one payer to Medicare, or vice versa. The covered-services list, the modifiers, the originating-site rules, and the geographic restrictions have all been moving targets.
Because Medicare’s telehealth policy is reviewed and adjusted on a recurring basis — sometimes with hard expiration dates attached to temporary flexibilities — the only safe approach is to check the current published list and guidance before you bill. Treat any specific Medicare telehealth rule you remember as potentially out of date until you’ve confirmed it against the present-day policy.
Where It Breaks
The Four Mistakes We See Most Often
When telehealth claims get denied or underpaid in behavioral health, the cause usually traces back to a short list of recurring errors. Most are preventable with a tight front-end process and periodic auditing of how claims are actually going out the door.
- POS 02 where POS 10 would pay more. The single most common silent underpayment — home-based sessions billed under the lower-rate place-of-service code out of habit or a hard-coded default.
- A missing or wrong modifier. Omitting 95 on a video visit, or appending a modifier the payer doesn’t recognize, sends the claim straight into a denial or a rework queue.
- Audio-only billed to a payer that doesn’t cover it. Behavioral health has more audio-only latitude than most specialties, but “more” is not “all.” Billing a phone session to a plan that excludes audio-only invites a clean denial.
- Modality and consent not documented. If the note doesn’t establish how the service was delivered — and, where required, that the patient consented to telehealth — the claim is exposed on audit even when the codes are technically correct.
None of these require exotic fixes. They require a payer-specific telehealth policy grid, billing templates that don’t silently default, and someone reconciling paid amounts against expected rates. That last step is where a structured revenue cycle management process catches the underpayments that otherwise slip by unnoticed, claim after claim.
FAQ
Frequently asked questions
Is modifier 95 or GT correct for a video therapy session?
For most payers today, 95 is the standard modifier for synchronous audio-video telehealth and GT is the legacy equivalent it replaced. However, a small number of payers and contracts still require GT. Check each payer’s current telehealth billing policy rather than applying one rule everywhere.
Can I bill a telephone (audio-only) behavioral health session?
Often, yes — behavioral health has retained more audio-only flexibility than most specialties, typically using modifier 93 for commercial payers (and Medicare’s own FQ for audio-only behavioral health). But coverage is not universal, so confirm that the specific payer and plan cover audio-only before relying on it.
Should I use POS 02 or POS 10 for telehealth?
It depends on where the patient is located. POS 10 applies when the patient is in their own home; POS 02 applies when they are somewhere else. Because the two can pay differently — with POS 10 frequently mapping to the higher non-facility rate — defaulting everything to 02 can underpay you. Verify how each payer maps these codes.
Do these telehealth rules change often?
Yes. Telehealth coding and coverage rules change frequently and differ by payer and by state, and Medicare in particular revises its telehealth list and flexibilities on a recurring basis. Always confirm current requirements with each payer before billing rather than relying on past guidance.
How can I tell if I’ve been underpaid on telehealth claims?
Compare the amount each payer actually paid against the rate you expected for that code, modifier, and place of service. Systematic gaps — especially on home-based visits billed as POS 02 — are a strong signal. A consistent reconciliation process is the most reliable way to surface these patterns.
Not Sure Your Telehealth Claims Are Coded Right?
We audit how your behavioral health telehealth visits are billed and find the modifiers and place-of-service codes that are costing you.