Tammie Posted Thu 19th of March, 2020 15:12:37 PM
Is there a listing somewhere for which payors except which modifier. Such as modifier 95 or modifier GT. I believe commercial payors are excepting the 95 and Medicaid and CMO's are excepting the GT. Can this be verified? The claims department says they are not coders.
SuperCoder Answered Fri 20th of March, 2020 07:52:43 AM
Thank you for your Question.
No, there is no such payer specific list present indicating the usage of modifier GT and 95 respectively. Payers accepting the modifier must be following their specific reimbursement guidelines.
Note: Modifier 95 is used when billing to private payers to indicate services were rendered via synchronous telecommunication. Please be noted, Medicare and Medicaid do not recognize modifier 95.
You are advised to get in touch with your respective payer to know about the telemedicine modifier requirement for proper reimbursement.
Hope this Helps!