Modifier 93 is a new audio-only telemedicine code that went into effect on Jan. 1, 2022. Modifier 93 describes services that are provided via telephone or other real-time interactive audio-only telecommunications system. Use of this modifier is appropriate only if the real-time interaction occurs between a physician/other qualified health care professional and a patient who is located at a distant site. When using modifier 93, the communication during the audio-only service must be of an amount or nature that meets the same key components and/or requirements of a face-to-face interaction.
To date, Medicare has not issued guidance on the use of modifier 93. Therefore, it is unclear exactly which codes can be used with this modifier for purposes of Medicare reimbursement. Notably, Medicare added more than 100 CPT codes to the telehealth services list for the duration of the COVID-19 public health emergency (PHE) and also temporarily waived the audio-video requirement for many telehealth services. The codes that have audio-only waivers during the PHE are noted in CMS’s list of telehealth services. Providers should refer to the policies of other payers to confirm authorized use of modifier 93.
Modifier 93 (Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System) will not be published in the AMA’s CPT book until 2023.
The Advocacy Council – ADVOCATING FOR ALLERGISTS AND THEIR PATIENTS
