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Adding a CPT modifier for Telehealth appointments

There are two different modifiers that can be used when billing a Telehealth appointment.

  1. If you're billing a commercial insurance payer, the modifier should be 95
  2. If you're billing Medicare, the modifier should be GT

Below you'll find the steps on adding modifiers to your insurance billing documents: 


Claims

  • Navigate to the client's Billing page 
  • Create a claim for the Telehealth appointment
  • Enter the Telehealth modifier manually into box 24D of the claim form  
  • Click Save or Submit 

modifier.simplepracitce.claimform.jpg


Superbills

To add a modifier to a superbill, you will need to create a custom service code:

  • Navigate to My Account > Settings > Billing and Services > Services
  • Click Add New Service 
  • Enter your custom service code with the modifier -95
    • For example, to add the Telehealth modifier to 90834, create code 90834-95
  • Enter the Description, Rate, Default Service Duration, and Booking Options
  • Click Save

services.simplepractice.billingandservices.jpg

Select the new custom service code for your Telehealth appointments. When you create the superbill for the appointment, you will notice that the modifier will be displayed next to the service code.

servicecode.simplepractice.superbill.jpg

 

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