Resolved G2211 TLH Modifier

[MistyR_46049]

Hello, I know that add on code G2211 cannot have modifier -95, or -GT appended to it however im looking for a source that has that documented. Thanks

 

[LindaL_84933]

Misty, for those modifiers, it appears only Medicaid prefers those on their telehealth visits. So depending on what insurance you are wanting to bill this code to, you would need to confirm the POS and if modifiers are appropriate. With the new Telemed policy most insurance do not accept require modifiers for those visits. Here are some links that may offer you some type of guidance on what modifiers are acceptable and what are not acceptable.

https://www.cms.gov/files/document/mm13473-how-use-office-and-outpatient-evaluation-and-management-visit-complexity-add-code-g2211.pdf

https://www.cms.gov/files/document/hcpcs-g2211-faq.pdf

 

[Raymond_62028]

I think one can find something regarding G2211 and such modifiers as -95 and -GT in CMS or AMA CPT. You could also consult with the payer’s policy or coding guideline because they always provide definition to these rules.