There are two different modifiers that are used when billing a Telemental health session.
- If you're billing a commercial insurance payer, the modifier should be "95."
- If you're billing Medicare, the modifier should be "GT"
How do I add the modifier to my claims?
You can manually add modifiers to your insurance claims in SimplePractice. Just go to a client's Billing page, create a claim, and manually add the modifier to box 24D of the claim form.
Once you've added the modifier to your claim, you can either Save or Submit your claim.
How do I add the modifier to my Superbills?
To add a modifier to a Superbill, you will need to create a custom code:
- Go to My Account > Settings > Billing > Services > Add New Service.
- Enter the information for the custom service code with the modifier "-95". For example, to add the telemental health modifier to 90834, create code "90834-95".
- Enter Description > Fee > Duration > any other options you'd like for this code > Save.
- When you create a Telehealth session you're going to need a Superbill for, make sure to use this code.
- When you create the Superbill, you will notice that the modifier will be displayed next to the CPT code.