Telehealth Place of Service and Modifiers 93 and 95 for Mental Health Billing
Modifiers 93 and 95 tell a payer how a telehealth visit was delivered: 95 means real-time audio and video, and 93 means audio only. The place of service (POS) code tells the payer where the patient was: POS 10 at home, POS 02 anywhere else. Current as of 9/30/26 — reconfirm with each payer before you bill.
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- ✓ POS 02 vs POS 10: what each one means
- ✓ Modifier 95 (audio and video) defined
- ✓ Modifier 93 (audio only) defined
- ✓ Medicare vs commercial payer differences
- ✓ What psychiatrists need to add
Two pieces of information on every telehealth claim
A telehealth claim tells the payer where the patient was and how the visit was delivered. The place of service code answers the first question. A modifier answers the second, when the payer wants one.
| Claim element | What it tells the payer | Examples |
|---|---|---|
| Place of service (POS) | Where the patient was during the visit | POS 10 (patient at home), POS 02 (patient anywhere else) |
| Modifier 95 | Real-time audio and video visit | 90834-95, 90837-95, 99214-95 |
| Modifier 93 | Real-time audio-only visit | 90834-93, 90837-93, 99214-93 |
| CPT code | The service performed | 90791, 90834, 90837, 99214 with 90833 |
POS 10 or POS 02: which one do I use?
The Centers for Medicare & Medicaid Services (CMS) defines POS 10 as telehealth provided in the patient’s home and POS 02 as telehealth provided other than in the patient’s home. Ask where the patient was at the start of the visit. Your location does not decide the code.
| POS | Definition | Use it when | Medicare payment rate |
|---|---|---|---|
| POS 10 | Telehealth provided in the patient’s home | The patient joins from their own home or residence | Non-facility rate |
| POS 02 | Telehealth provided other than in the patient’s home | The patient joins from a car, office, school, library or any place that is not home | Facility rate |
Source for the definitions: CMS Place of Service Code Set. Modifiers 93 and 95 do not change which POS you pick. Payment rates: since 1/1/2024, Medicare pays POS 02 at the facility rate and POS 10 at the non-facility rate. Commercial payers set their own rules, so confirm each one. See the full place of service code list for in-person codes.
What modifiers 93 and 95 mean
A modifier is a two-character add-on to a CPT code that adds detail about how a service was delivered. Modifier 95 means synchronous (real-time) telemedicine using audio and video. Modifier 93 means synchronous telemedicine using audio only.
| Modifier | Definition | Use it for | Watch for |
|---|---|---|---|
| 95 | Synchronous telemedicine service rendered via real-time interactive audio and video | A live video visit | Many commercial payers require it. On Medicare, the modifier does not change the payment amount. |
| 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system | A live phone visit, when the payer allows audio-only | Some payers want it only when the patient cannot or will not use video. Documentation should say why. |
Other telehealth modifiers exist and apply in narrow settings: FQ (audio-only on rural health clinic and federally qualified health center claims), GT (critical access hospital Method II institutional claims) and GQ (asynchronous demonstrations in Alaska and Hawaii). Most private mental health practices will not use them. Full list on the CPT modifiers page.
How Medicare, Medicaid and commercial payers handle modifiers 93 and 95
Medicare, state Medicaid programs and commercial plans each set their own telehealth billing rules. They often conflict. Treat every payer separately and keep a one-page cheat sheet per payer.
Medicare
Medicare telehealth flexibilities were extended through 12/31/2027 by H.R. 7148 (the Consolidated Appropriations Act, 2026), signed 2/3/2026. Telehealth for mental and behavioral health in the patient’s home, with no geographic restriction, is permanent. For Medicare, an in-person visit is not required until 1/1/2028, when a visit within the prior 12 months for established patients begins to apply to home-based mental health telehealth. Details and exceptions are on the CMS telehealth page. Whether to append modifier 95 on a Medicare professional claim from a private practice depends on your Medicare Administrative Contractor (MAC), so check its current guidance.
State Medicaid
Rules vary by state. Some states require POS 02 or 10 with modifier 95. Others accept POS alone. Read your state Medicaid manual and each managed care plan’s provider manual. Our Medicaid HCPCS guide links to state manuals.
Commercial payers
Many commercial plans want POS 02 or 10 and modifier 95 (some accept GT instead). Audio-only coverage differs plan by plan. Verify with the payer before you bill, and save the answer in writing.
What psychiatrists and prescribers need to add
Psychiatrists bill telehealth visits with an evaluation and management (E/M) code, with or without a psychotherapy add-on. The same POS and modifier logic applies, and prescribing adds its own rules.
- E/M plus add-on: 99214 with 90833 or 90836 takes the same POS and, where required, the same modifier on both lines.
- Controlled substances: the Drug Enforcement Administration (DEA) telemedicine flexibilities for prescribing controlled substances were extended through 12/31/2026, and a special registration rule is still pending as of 9/30/26. Check the DEA Diversion Control Division before year-end.
- Electronic prescribing: confirm your EHR’s rules for controlled-substance e-prescribing (EPCS) with your vendor.
What to do Monday morning
Set your defaults once so modifiers 93 and 95 and the POS code come out the same way on every telehealth claim.
- Add a required field to your notes: patient location at start of visit (home or elsewhere).
- Set your EHR to POS 10 for home and POS 02 for everywhere else.
- List each payer and whether it wants modifiers 93 and 95, GT or none.
- Document audio-only visits with the reason video was not used.
- Run 10 recent telehealth claims through each payer’s portal and fix denials.
Telehealth POS and modifiers 93 and 95: frequently asked questions
What is the difference between POS 02 and POS 10?
POS 10 is telehealth with the patient at home. POS 02 is telehealth with the patient anywhere else. The patient’s location decides the code, not the provider’s location. Since 1/1/2024, Medicare pays POS 10 at the non-facility rate and POS 02 at the facility rate.
What does modifier 95 mean?
Modifier 95 tells the payer the service was a synchronous telemedicine visit delivered with real-time audio and video. Many commercial payers require it. It does not change the Medicare payment amount.
What does modifier 93 mean?
Modifier 93 tells the payer the service was a synchronous telemedicine visit delivered by audio only. Coverage depends on the payer, and some want documentation of why video was not used.
Do I need both a POS code and modifiers 93 and 95?
Often yes, but it depends on the payer. Medicare uses POS 02 or 10 to identify telehealth. Many commercial payers also want modifier 95. Confirm with each payer and keep the answer on file.
Are Medicare telehealth flexibilities permanent?
Partly. Mental health telehealth in the patient’s home with no geographic limit is permanent. Other flexibilities were extended through 12/31/2027 by H.R. 7148, and the in-person visit requirement for home-based mental health telehealth begins 1/1/2028. Reconfirm on CMS.gov before you rely on a date.
Where this information comes from
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