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.
Use A Four Part Check Before You Change A Claim
Every behavioral health telehealth claim has to answer two separate questions: how the visit happened, and where the patient was. Modifiers such as 95, 93, GT or FQ describe the service or delivery method under the payer's rules. POS 02 and POS 10 describe the patient's location. You can’t swap one for the other.
- 1. What Service Was Provided?
- Confirm the supported service and code first. A telehealth modifier does not make an otherwise excluded service payable.
- 2. Was The Visit Video Or Audio Only?
- Document the actual format. Check the payer’s current instructions for the code, provider type, and setting before choosing 95, 93, GT, FQ, or no modifier.
- 3. Where Was The Patient?
- CMS defines POS 10 for telehealth in the patient’s home and POS 02 for telehealth somewhere other than the patient’s home. Confirm how the payer applies those codes to your claim.
- 4. Which Policy Applied On The Service Date?
- Record the payer product, policy date, claim format, and any setting specific instructions. A rule for a commercial plan, Medicare professional claim, or health center does not automatically apply to the others.
2026 Medicare update: CMS’s February 26 FAQ says the mental health telehealth in person visit requirements take effect after December 31, 2027. Use that current FAQ rather than a page that still lists an early 2026 deadline.
Official sources reviewed September 2, 2026: CMS place of service guidance, CMS Telehealth And Remote Monitoring, and the February 26, 2026 Telehealth FAQ.
The Modifiers
95, 93, And GT: What Each One Tells The Payer
Modifiers are the two-character flags added to a CPT code to tell the payer how a service was delivered. In behavioral health telehealth, three come up over and over. Get one wrong and the claim bounces back for “invalid modifier,” or worse, it quietly pays at the wrong rate.
Modifier 95: Synchronous Audio-Video
This is the workhorse for live video. Modifier 95 signals a synchronous, real-time encounter over interactive audio and video, and for the vast majority of commercial telehealth therapy and psychiatry visits done by video, 95 is the one you’ll use most.
Modifier 93: Audio-Only
Modifier 93 identifies audio-only (telephone) services. Behavioral health kept more audio-only flexibility than most specialties, and that matters for clients who can’t or won’t use video. Coverage still varies a lot by payer. Confirm it for the specific plan before you rely on it.
Modifier GT: The Legacy Flag
GT was the original audio-video telehealth modifier. It’s been largely replaced by 95, but a handful of payers and contracts still require it. Don’t assume it’s dead. Check that payer’s current guidance before you drop it from a claim that used to need it.
These descriptions are general. Each payer publishes its own modifier requirements and may accept, require or reject a given modifier in ways that break from the norm, and those policies change. Check the payer’s current telehealth billing policy every time.
Place Of Service
POS 02 Vs. POS 10: The Split That Quietly Costs Practices Money
Until 2022, telehealth had one place-of-service code: 02. Then it split in two, and the line between them is where the patient is located during the visit. Where the provider sits doesn’t matter. It’s one of the most common sources of telehealth underpayment in behavioral health, precisely because it’s so easy to leave everything on the old, familiar 02.
POS 10: Patient At Home
Use POS 10 when the patient is in their own home. Many payers map POS 10 to the non-facility rate, which is frequently the higher of the two. For home-based behavioral telehealth, it’s often both the correct code and the better-paying one.
POS 02: Patient Elsewhere
POS 02 covers telehealth delivered anywhere other than the patient’s home, such as a clinic, a facility or some other location. It can pay at a different, often lower, rate than POS 10. That’s exactly why defaulting every telehealth claim to 02 can underpay you on claim after claim.
Don’t let your EHR or billing template hard-code POS 02 for all telehealth. Most behavioral health telehealth happens with the client at home, so billing 02 across the board can leave money on the table on a large share of your visits. Find out how each payer maps these codes to its fee schedule. If this lives inside a practice-management platform, our notes on SimplePractice billing show where those settings usually sit and how the defaults can trip you up.
Medicare
Medicare Plays By Its Own Telehealth Rules
Medicare doesn’t mirror commercial payer conventions. It keeps its own list of covered telehealth services and its own telehealth modifiers, and that framework has been extended and revised over and over through legislative and regulatory action. What was true a year ago may not be true today.
Here’s one that matters for behavioral health. Medicare uses modifier FQ to show a behavioral health service was furnished audio-only, which is different from the commercial-world modifier 93. You can’t assume a modifier or place-of-service convention carries over cleanly from a commercial payer to Medicare, or the other way around. The covered-services list, the modifiers, the originating-site rules and the geographic restrictions have all been moving targets.
Medicare reviews and adjusts its telehealth policy on a recurring basis, sometimes with hard expiration dates on temporary flexibilities, so the only safe approach is to check the current published list and guidance before you bill. Memory doesn’t count. Any specific Medicare telehealth rule you remember might be out of date until you’ve checked it against today’s policy.
Where It Breaks
The Four Mistakes We See Most Often
When behavioral health telehealth claims get denied or underpaid, the cause usually traces back to the same short list. Most of it is preventable. You need a tight front-end process and a periodic audit of how claims are actually going out the door.
- POS 02 where POS 10 would pay more. It’s the single most common silent underpayment: home-based sessions billed under the lower-rate place-of-service code out of habit, or because somebody hard-coded a 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” isn’t “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 need exotic fixes. What they need is 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. A small number of payers and contracts still require GT, though. Check each payer’s current telehealth billing policy instead of applying one rule everywhere.
Can I Bill A Telephone (Audio-Only) Behavioral Health Session?
Often, yes. Behavioral health has kept more audio-only flexibility than most specialties, usually billed with modifier 93 for commercial payers and Medicare’s own FQ for audio-only behavioral health. Coverage isn’t universal, though, so confirm that the specific payer and plan cover audio-only before you rely on it.
Should I Use POS 02 Or POS 10 For Telehealth?
It depends on where the patient is. POS 10 applies when the patient is in their own home, and POS 02 applies when they’re somewhere else. The two can pay differently, with POS 10 frequently mapping to the higher non-facility rate, so defaulting everything to 02 can underpay you. Check 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. Confirm current requirements with each payer before billing. Past guidance isn’t a safe basis.
How Can I Tell If I’ve Been Underpaid On Telehealth Claims?
Compare what each payer actually paid against the rate you expected for that code, modifier and place of service. Systematic gaps are a strong signal, especially on home-based visits billed as POS 02. The most reliable way to surface these patterns is a reconciliation process you run consistently.
Next Step
Know What This Would Cost For Your Practice.
Every service has a published price and a written scope. If you are not sure which one fits, ask and you will be pointed at the right one.