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Telehealth services
Last Modified: 4/8/2025
Location: FL, PR, USVI
Business: Part A, Part B
Telehealth services are defined as services a physician or practitioner provides via two-way, interactive technology (or telehealth). Telehealth substitutes for an in-person visit and generally involves two-way, interactive technology permitting communication between the practitioner and patient.
Interactive telecommunications system means multimedia communications equipment including, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner.
In the
CY 2025 Physician Fee Schedule (PFS) final rule 
, CMS permanently changed the definition of “interactive telecommunications system” to include two-way, real-time audio-only communication technology for any telehealth service furnished to a patient in their home, provided that the furnishing physician or practitioner is technically capable of using audio-video communication technology and that the beneficiary is not capable of or does not consent to using audio-video communication technology. Audio-only can be used for both new and established patients.
• In general, audio-only telehealth services are only permitted if the beneficiary is in his or her home. All other originating sites are medical facilities with the capabilities to support two-way, audio/video communication technology.
For behavioral or mental telehealth, you may use two-way, interactive, audio-only technology. The patient must be in their home.
A distant site is the location from where a physician or practitioner provides telehealth. Through September 30, 2025, all providers who are eligible to bill Medicare for professional services can provide distant site telehealth.
Through CY 2025, distant site practitioners may continue to use their currently enrolled practice location instead of their home address when providing Medicare telehealth services from their home.
Eligible providers
The following distant site practitioners can furnish and receive payment for covered telehealth services include:
• Nurse practitioners (NPs)
• Physician assistants (PAs)
• Clinical nurse-midwives (CNM)
• Clinical nurse specialists (CNS)
• Certified registered nurse anesthetists (CRNAs)
• Clinical psychologists (CPs)
• Clinical social workers (CSWs)
• Registered dietitians (RDs)
• Nutrition professionals
• Mental health counselors (MHC)
• Marriage family therapists (MFT)
The following distant site health care professionals are eligible to bill telehealth services through September 30, 2025:
• Audiologists
• Occupational therapist (OT)
• Physical therapist (PT)
• Speech language pathologist (SLP)
Note: Distant site professionals may be limited by state scope of practice.
An originating site is the location where a patient is located while receiving physician or practitioner medical services through telehealth.
Through September 30, 2025, all patients can receive telehealth wherever they are located. They do not need to be at a designated originating site and there are no geographic restrictions.
For dates of service on and after October 1, 2025:
• Non-behavioral or mental telehealth -- There are originating site requirements and geographic location restrictions.
• Behavioral or mental telehealth -- All patients can continue to receive telehealth wherever they are located, with no originating site requirements or geographic location restriction.
• The patient’s home is a permissible originating site for services provided for diagnosing, evaluating, or treating:
• Mental health disorders
• Substance abuse disorder
• Monthly ESRD-related clinical assessment
HCPCS Code Q3014 describes the Medicare telehealth originating sites facility fee. The Medicare originating site facility fee amount for CY 2024 is $31.01.
An originating site facility fee can only be billed when the patient is in a healthcare facility receiving telehealth. Medicare makes payment to the distant site practitioner for the professional services.
Note: If the patient is within a hospital and receives a hospital outpatient clinic visit (including a mental or behavioral health visit), from a practitioner located in the same physical location, the hospital would bill for the clinic visit (HCPCS code G0463).
Originating Site |
Payment Methodology |
Bill type |
Revenue Code |
Outpatient hospital - includes rural emergency hospitals (REHs) |
Outside of outpatient prospective payment system (OPPS) |
13X |
078X |
Inpatient hospital |
Outside diagnostic related group codes (DRGs) |
12X |
078X |
Critical access hospital (CAH) |
Separate from cost based (80% or the originating site facility fee) |
12X |
078X |
Federally Qualified Health Center (FQHC) or Rural Health Center (RHC) |
Separate from Prospective Payment System (PPS) or All-Inclusive Rate (AIR) |
77X or 71X |
078X |
Hospital-Based or CAH-Based Renal Dialysis Center |
In addition to ESRD PPS or monthly capitation payment |
72X |
078X |
Skilled nursing facility (SNF) |
Outside of the SNF PPS (not subject to consolidated billing) |
22X or 23X |
78X |
Community mental health center (CHMC) |
Not a partial hospitalization service (or used to determine payment for partial hospitalization). Not bundled in per diem |
76X |
078X |
For physician and practitioner offices, the only payable setting for originating site is office, place of service (POS) 11, and the payment amount is the lesser of 80% of the actual charge or 80% of the originating site facility fee, regardless of geographic location.
An originating site can include the home of individual for certain purposes related to ESRD, SUDs and mental health or a mobile stroke unit.
• There are three finalized action categories:
• Maintain:
• Provisional -- services listed will have refinements to the telehealth policies based on certain provisions.
• Permanent -- will remain on the telehealth listing.
• Addition:
• New services added that are either provisional or permanent.
• Delete:
• Codes have been deleted..
Modifiers
Telehealth modifiers should be submitted with distant site telehealth services. Generally, interactive audio and video communications must be used to permit real-time communication between distant site physician or practitioner and patient. Patient must be present and participating in telehealth visit.
Modifier |
Description |
Additional notes |
93 |
Telehealth modifier defined as "synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system." |
Modifier 93 is used for audio only communication: • Permitted for patients in their home if patient does not have: • Technical capacity • Availability of real-time audio and visual interactive technology • Permitted for patients in their home if patient does not: • Consent to the use of two-way, audio/video technology Opioid Treatment Programs (OTPs) report on claims for intake activities, periodic assessments, counseling and therapy provided for audio-only technology: RHCs and FQHCs can report either modifier 93 or FQ for services provided by audio-only technology. |
95 |
Telehealth modifier defined as synchronous telemedicine service rendered via real-time Interactive audio and video telecommunications system. |
For institutional billing, use modifier 95 for dates of service on and after January 1, 2024, through September 30, 2025, when: • The clinician is in the hospital and the patient is in their home. • Outpatient therapy provided via telehealth by PTs, OTs or SLPs employed by hospitals. OTPs report on claims for intake activities, periodic assessments, counseling and therapy provided for audio-only technology: |
FQ |
The service was furnished using audio-only communication technology. |
This modifier is only used by RHCs and FQHCs |
G0 (zero) |
Telehealth services furnished for purposes of diagnosis, evaluation, or treatment of symptoms of an acute stroke. |
Valid for: • Telehealth distant site codes billed with place of service (POS) code 02; or • CAH method II (revenue codes 096X, 097X, or 098X); or Telehealth originating site facility fee, billed with HCPCS code Q3014. |
GQ |
Telehealth service rendered via asynchronous telecommunications system. |
Certifying the collection and transmission of the asynchronous medical file at the distant site from a federal telemedicine demonstration conducted in Alaska or Hawaii. |
GT |
Telehealth service via interactive audio and video telecommunication systems. * |
*Only allowed on institutional claims billed by CAH method II providers. |
Report the following POS as appropriate for telehealth services to indicate where the patient was located when receiving telehealth services:
• POS 02 -- Telehealth Provided Other than in Patient’s Home
Descriptor: The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in the home when receiving health services or health related services through telecommunication technology.
Services are reimbursed at the facility rate
• POS 10 -- Telehealth Provided in Patient’s Home
Descriptor: The location where health services and health related services are provided or received through telecommunication technology. Patient is in the home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
Telehealth services provided to in patient homes will be reimbursed at the non-facility PFS rate.
The Full Year Continuing Appropriations and Extensions Act, 2025 extended the expansion of the types of practitioners eligible to furnish Medicare telehealth services through September 30, 2025, thus enabling PTs, OTs, and SLPs to continue furnishing telehealth services through that date. CMS is continuing to align requirements for payment for services furnished remotely by hospital staff to beneficiaries in their homes, including remotely furnished outpatient therapy services, DSMT, and MNT services, with requirements for Medicare telehealth services. Therefore, through September 30, 2025, hospitals can continue to bill for these services when furnished remotely by hospital staff to beneficiaries in their homes.
Teaching physicians may have virtual presence when billing for services provided involving residents in all teaching settings, but only in clinical situations when the service is provided virtually (for example, a 3-way telehealth visit with the patient, resident, and teaching physician in separate locations) through December 31, 2025.Consent for care management and virtual communication services
CMS requires patient consent for all services, including non-face-to-face services. Providers may obtain patient consent at the same time you initially provide the services. Direct supervision is not required to get consent.
In general, auxiliary personnel under general supervision of the billing practitioner can obtain patient consent for these services. The person getting consent can be an employee, independent contractor, or leased employee of the billing practitioner.
The
Acute Hospital Care at Home (AHCaH) initiative 
is a flexibility to allow hospitals to expand their capacity to provide inpatient care in an individual's home implemented by CMS during the COVID-19 PHE. This relies heavily on telehealth for hospitals to provide inpatient services including routine services, outside the hospital.
Per the Full Year Continuing Appropriations and Extensions Act, 2025, the AHCaH initiative has been extended through September 30, 2025. For all hospitals with active AHCAH waivers, all inpatients must be discharged or returned to the hospital on September 30, 2025, in the absence of Congressional action to extend the initiative.
CMS will no longer accept waiver requests for participation in the AHCAH initiative after September 1, 2025.
Independent and provider based FQHCs and RHCs bill their Part A MAC using the FQHC and RHC bill type and provider number.
• Report revenue code 078X when billing for the originating site facility fee for both FQHCs and RHCs.
Additional information on distant site billing for FQHCs and RHCs can be found in the following resources:
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