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Resolved Modifier 93

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Lori

Well-known member
New Audio Only Telemedicine CPT Modifier Effective January 1, 2022
The American Medical Association has created a new modifier, Modifier 93, to describe real-time telemedicine services between a patient and their physician, or other qualified healthcare professional, using audio only telecommunications systems. The panel approved the new code at the September 2021 CPT Editorial Panel Meeting. Modifier 93 should only be used when the service is of an amount and nature that would meet the key components and/or requirements of the same service if it were rendered via a face-to-face interaction.
Modifier 93 descriptor
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.

 
This modifier is not for when it is just a telephone call correct? We would use regular E/M codes with this modifier? I'm trying to figure out what type of telecommunication system would be used that is audio only - most providers only indicate it is a telephone call which I have been coding 99441-99443. I'm guessing this is not the same thing and want to be sure to educate providers on their correct documentation practices.
 
There is not much guidance on the new modifier.

Please see the links posted below to other threads on telemedicine/ telehealth.

Screen Shot 2021-12-29 at 8.52.08 AM.png



https://www.cco.community/threads/t...ne-guide-what-is-telemedicine.3572/#post-4693

https://www.cco.community/threads/covid-19-telehealth-cheatsheet-by-innovihealth.4245/

 
There is not much guidance on the new modifier.

Please see the links posted below to other threads on telemedicine/ telehealth.

View attachment 1373



https://www.cco.community/threads/t...ne-guide-what-is-telemedicine.3572/#post-4693

https://www.cco.community/threads/covid-19-telehealth-cheatsheet-by-innovihealth.4245/


Yes, these are the same articles/resource material I found too. I'll check with providers - they could possibly be using telemedicine but the patient only has audio and no visual screen on their end. I could see some elderly potentially not having a computer and/or smartphone.

Thanks!
 
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