Telemedicine Modifier 93 Updates 2022

The modifier 93 (Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System).

Modifier 93 is a new audio-only telemedicine code that is effective on Jan. 1, 2022. Modifier 93 describes services that are provided via telephone or other real-time interactive audio-only telecommunications systems.

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 this 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 face-to-face interaction.

Addition of Appendix T

This appendix is a listing of CPT codes that may be used for reporting audio-only services when appended with Modifier 93. Procedures on this list involve electronic communication using interactive telecommunications equipment that includes, at a minimum, audio. The codes listed in Appendix T will be identified with an audio speaker symbol in the 2023 code set. The list of codes contained in the appendix, used with Modifier 93, is effective April 1, 2022.

The below summary of CPT codes that may be used for reporting audio only services when appended with Modifier 93.

The Procedures on this list involve electronic communication using interactive telecommunications equipment that includes, at a minimum, audio. The codes listed below are identified with the audio symbol.

90785 Interactive complexity (List separately in addition to the code for primary procedure)

 

90791 Psychiatric diagnostic evaluation

 

90792 Psychiatric diagnostic evaluation with medical services

 

90832 Psychotherapy, 30 minutes with patient

 

90833 Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

 

90834 Psychotherapy, 45 minutes with patient

 

90836 Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

 

90837 Psychotherapy, 60 minutes with patient

 

90838 Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

 

90839 Psychotherapy for crisis; first 60 minutes

 

90840 Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service)

 

90845 Psychoanalysis

 

90846 Family psychotherapy (without the patient present), 50 minutes

 

90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes

 

92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual

 

92508 Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals

 

92521 Evaluation of speech fluency (eg, stuttering, cluttering)

 

92522 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria)

 

92523 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)

 

92524 Behavioral and qualitative analysis of voice and resonance

 

96040 Medical genetics and genetic counseling services, each 30 minutes face to face with patient/family

 

96110 Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument

 

96116 Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face to face time with the patient and time interpreting test results and preparing the report; first hour

 

96160 Administration of patient focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument

 

96161 Administration of caregiver focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument

 

97802 Medical nutrition therapy; initial assessment and intervention, individual, face to face with the patient, each 15 minutes

 

97803 Medical nutrition therapy; reassessment and intervention, individual, face to face with the patient, each 15 minutes

 

97804 Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes

 

99354 Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; first hour (List separately in addition to code for outpatient Evaluation and Management or psychotherapy service, except with office or other outpatient services [99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215])

 

99355 Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)

 

99356 Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient or observation Evaluation and Management service)

 

99357 Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)

 

99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes

 

99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes

 

99408 Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes

 

99409 Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes

 

99497 Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face to face with the patient, family member(s), and/or surrogate

 

99498 Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)

Documentation

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 face-to-face interaction.