AMA Releases New CPT Code Modifier For Audio-Only Telehealth
The American Medical Association (AMA) has released new CPT code modifier 93 for audio-only telehealth services. The AMA approved the modifier at the September 2021 CPT editorial meeting; AMA made it available on their website on December 30, 2021. The code became effective two days later on January 1, 2022. It will appear in the print version of CPT 2023.
As a result of the COVID-19 Public Health Emergency (PHE), CMS has issued waivers. These expanded the services that may be provided via telehealth. CMS updated the 2022 list of services payable under the Medicare Physician Fee Schedule when furnished via telehealth in 2021; those that are eligible for audio-only interaction are indicated in a separate column within the listing. For example, 90792, Psychiatric diagnostic evaluation with medical services, appears in the column titled “Can Audio Only Interaction Meet the Requirement” in the list of Medicare Telehealth Services.
Furthermore, CPT modifier 93 joins existing modifier 95 for telemedicine services rendered via audio and video systems. AMA’s full description of the modifier includes important definitions and other information. We’ve included the description below:
“93 Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System“
Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.”
Latest Updates As Of January 22, 2022
The 2022 Medicare Physician Fee Schedule has two additional modifiers related to Telehealth Services, specifically telehealth mental health services. FQ: A telehealth service was furnished using real-time audio-only communication technology. FR: A supervising practitioner was present through a real-time two-way, audio/video communication technology. As a result, the Telehealth Services List has been updated to reflect these changes.
We’ve previously written about the changes in telehealth coding, as well as debates surrounding how Medicare will reimburse audio-only telehealth. You can find that article here. For more information, visit YES HIM’s Telehealth Resource Center.