CPT modifier for Telemental health

There are two different modifiers that are used when billing a Telemental health session.

  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"

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. 


Box 24D of the claim form is where you can manually add modifiers

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:

  1. Go to My Account > Settings > Billing > ServicesAdd New Service.
  2. 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".
  3. Enter Description > Fee > Duration > any other options you'd like for this code > Save.
  4. When you create a Telehealth session you're going to need a Superbill for, make sure to use this code.
    Adding an a code with a modifier on the calendar flyout in SimplePractice
  5. When you create the Superbill, you will notice that the modifier will be displayed next to the CPT code.
    The modifier will be shown next to the CPT code on the Superbill


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