Blog, Medical Coding

GT vs 95 Modifier: Which Telehealth Modifier To Use?

July 14, 2026

Telehealth is now a permanent part of U.S. healthcare delivery, but one small detail still trips up billing teams every day: which modifier goes on the claim. GT or 95? Both describe a live video visit. Both have been used for years. And picking the wrong one for the wrong payer produces the same result either way, a denial that was completely avoidable. The confusion is understandable because the answer has changed over time and still depends on who is paying the claim.

This guide explains what modifier 95 and modifier GT actually mean, how the landscape stands today, where GT still applies, how GQ and audio-only modifiers fit in, and the place of service rules that travel with all of them. Everything here is general billing education only.

What Is Modifier 95?

Modifier 95 is the CPT modifier for a synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system. In plain language, it tells the payer the visit happened as a live video session instead of in person.

Key facts about modifier 95:

It was introduced by the AMA in January 2017 and is now the standard telehealth modifier for Medicare and most commercial payers.
It applies only to synchronous (real-time) audio and video visits, not phone-only calls, and not recorded content reviewed later.
It can only be appended to CPT codes that are telehealth-eligible, which,h for CPT purposes, es are listed in Appendix P of the CPT manual, and for Medicare purposes on the CMS telehealth services list.
It goes on the claim line next to the CPT code, for example,ple 99214-95 or 90834-95.

Modifier 95 does not replace documentation. The medical record must still independently support the service level, the telehealth delivery method, and medical necessity.

Also Read: Modifier 95 Ultimate Guide: Description, Usage & Examples

What Is Modifier GT?

Modifier GT is an older HCPCS modifier,fier meaning the service was provided via interactive audio and video telecommunication systems. Functionally, it describes the same clinical scenario as modifier 95: a live, synchronous video visit.

The difference is in origin and history. GT came from CMS and was the standard Medicare telehealth modifier for years. Then the AMA introduced modifier 95, Medicare shifted its professional claim requirements toward place of service codes and modifier 95, and most commercial payers followed. Today, GT survives in specific pockets rather than as the universal telehealth marker it once was.

Where GT still actively applies:

Many state Medicaid programs, especially those that have not updated their pre-pandemic telehealth policies.
Institutional claims billed by distant site practitioners under the Critical Access Hospital (CAH) Optional Payment Method II.
A shrinking set of legacy commercial payer contracts that never migrated to modifier 95.

So the direct answer to “Is the GT modifier still valid?” is yes, but only where the payer specifically requires it. It is not obsolete, and it is not the default.

GT vs 95: Side-by-Side Comparison

Factor	Modifier GT	Modifier 95
Full meaning	Via interactive audio and video telecommunication systems	Synchronous telemedicine via real-time interactive audio and video
Origin	CMS (HCPCS Level II)	AMA (CPT), introduced January 2017
Service type	Live audio-video only	Live audio-video only
Medicare professional claims	No longer used	Current standard
Medicare institutional claims	Still used under CAH Method II	Not the vehicle for that scenario
Medicaid	Still required by many state programs	Accepted by some, not all
Commercial payers	Required by a shrinking legacy subset	Standard for most major payers
Code restrictions	Payer-specific telehealth lists	Appendix P and payer telehealth lists
Stacking with the other	Never stack GT and 95 on one line unless a payer explicitly instructs it	Same rule

The most important takeaway from this table: GT and 95 describe the same clinical event. The choice between them is driven entirely by the payer, not by the technology, the specialty, or the CPT code.

The Quick Answer by Payer Type

For teams that just need the working rule:

Medicare (professional claims): Use modifier 95 with the correct place of service. GT on a Medicare professional claim signals an outdated workflow and can cause processing problems depending on the contractor.
Medicaid: check the specific state program. Many state Medicaid plans and Medicaid managed care organizations still require GT.
Commercial payers: Most large national payers have aligned with modifier 95, but individual contracts vary. Verify before assuming.
CAH Method II institutional billing: GT remains the correct modifier for distant site practitioners in that setting.

Practices with a mixed payer population usually need both modifier workflows running in parallel, backed by a payer-specific modifier matrix that the billing team can reference at claim submission.

Where GQ, 93, and FQ Fit In

The keyword confusion does not stop at GT and 95. Three more telehealth modifiers show up regularly:

Modifier GQ: asynchronous telecommunications, also called store-and-forward. The patient’s images, video, or data are recorded and reviewed by the provider later, not in real time. Its classic use is the federal telemedicine demonstration programs in Alaska and Hawaii, and certain FQHC and RHC scenarios. GQ is never correct for a live video visit.
Modifier 93: audio-only telehealth, meaning a real-time phone visit with no video, is used where the payer covers audio-only services. Audio-only behavioral health has permanent Medicare coverage pathways, while other specialties face tighter limits.
Modifier FQ: used for certain audio-only behavioral health services under Medicare rules.

The GT vs GQ distinction is simple once framed correctly: GT is live and interactive, GQ is delayed and recorded. They are not interchangeable, and using a telehealth video modifier on an audio-only visit is a routine denial cause.

Telehealth Modifier Family Quick Reference

Modifier	What It Signals	Typical Use
95	Real-time audio-video visit	Default for Medicare and most commercial telehealth
GT	Real-time audio-video visit	State Medicaid programs that require it, CAH Method II institutional claims
GQ	Asynchronous store-and-forward	Federal demonstration programs, select FQHC/RHC scenarios
93	Real-time audio-only visit	Phone visits where the payer covers audio-only
FQ	Audio-only behavioral health	Medicare behavioral health audio-only rules

Place of Service: The Other Half of the Claim

Modifiers rarely travel alone on telehealth claims. Place of service (POS) codes tell the payer where the patient was, and they directly affect whether the claim pays at the facility or non-facility rate.

POS 10 Telehealth is provided while the patient is in their home.
POS 02: telehealth provided while the patient is somewhere other than their home, such as a clinic or facility.
POS 11 (office) on a home-based telehealth visit is a common EHR default error. It processes the claim as an in-person service, often at the wrong rate, and creates an audit flag.

Part of Medicare’s move away from GT was exactly this: the POS code now carries much of the “this was telehealth” signal, with modifier 95 confirming the synchronous audio-video method.

Also Read: Modifier 25 Explained: Definition, Examples, CPT Usage Guidelines

Behavioral Health Examples

Behavioral health generates a large share of GT vs 95 questions because psychotherapy codes dominate telehealth volume. A few practical patterns:

A 45-minute video therapy session for a commercially insured patient is typically billed as 90834-95 with POS 10 if the patient was at home.
The same session for a state Medicaid patient may need to go out as 90834-GT if that program still requires GT.
Legacy claims like 90837-GT reflect the older convention. For Medicare and most commercial payers today, that same session is 90837-95.
An audio-only therapy call is not GT or 95 territory at all. Where covered, modifier 93 or the applicable behavioral health audio-only pathway applies.

The session is identical in every case. Only the payer’s rulebook changes the modifier.

Common Pitfalls That Drive Telehealth Denials

At Zee Medical Billing LLC, we often see the same modifier patterns cause avoidable denials across practices:

Defaulting to modifier 95 for every payer, then getting rejections from Medicaid plans that require GT.
Still applying GT to Medicare professional claims from a workflow that was never updated.
Stacking GT and 95 on the same claim line without payer instruction.
Using a video modifier (GT or 95) on an audio-only visit instead of modifier 93, where applicable.
Leaving POS 11 in place for home-based telehealth instead of POS 10.
Appending modifier 95 to CPT codes that are not on the payer’s telehealth-eligible list.
Forgetting the modifier entirely, which makes a telehealth visit look like an in-person service,e and can be treated as a billing inaccuracy if audited.
Having no payer-specific modifier matrix,o each biller relies on memory.

Most telehealth denials in this space are process failures, not knowledge failures. A one-page payer matrix, checked at submission, prevents nearly all of them.

FAQs

What is the difference between the GT and 95 modifier?

Both modifiers describe the same thing: a live, synchronous telehealth visit using real-time audio and video. The difference is in origin and current acceptance. GT is the older CMS HCPCS modifier, while 95 is the AMA CPT modifier introduced in 2017. Today, modifier 95 is the standard for Medicare professional claims and most commercial payers, while GT remains required by many state Medicaid programs, CAH Method II institutional claims, and some legacy commercial contracts. The payer’s policy, not the service itself, determines which one goes on the claim.

Is the GT modifier still valid?

Yes, but only in specific contexts. GT has not been formally retired everywhere. It remains actively required by many state Medicaid programs, by distant site practitioners billing institutional claims under the Critical Access Hospital Optional Payment Method II, and by a subset of commercial payers that never migrated to modifier 95. What GT is no longer is the universal telehealth modifier. Using it on Medicare professional claims or with payers that require 95 will create processing problems or denials.

Do you use the 95 or GT modifier for Medicare telehealth?

For Medicare professional claims, use modifier 95 along with the correct place of service code (POS 10 for a patient at home, POS 02 for other locations). Medicare moved away from GT on professional claims years ago, shifting the telehealth signal to POS codes plus modifier 95. The main remaining Medicare use of GT is institutional billing under the CAH Optional Payment Method II. Since Medicare Administrative Contractor handling can vary, teams should confirm current MAC guidance as part of their workflow.

What is the difference between the GT and GQ modifiers?

GT indicates a live, interactive audio and video visit happening in real time. GQ indicates asynchronous telehealth, also called store-and-forward, where images, video, or patient data are captured first and reviewed by the provider later. The two are never interchangeable. GQ’s classic use is the federal telemedicine demonstration programs in Alaska and Hawaii, plus certain FQHC and RHC scenarios. Using GQ on a live video visit, or GT on a store-and-forward service, is a straightforward denial.

When should modifier 95 be used?

Modifier 95 should be used when a covered service is delivered through real-time, interactive audio and video, the payer follows the modifier 95 convention (Medicare professional claims and most commercial payers), and the CPT code is on the applicable telehealth-eligible list, such as CPT Appendix P or the payer’s own list. It should be paired with the correct place of service code, and the documentation must independently support the service level and the telehealth delivery method. It should not be used for audio-only calls or asynchronous services.

Conclusion

The GT vs 95 question has a clean answer once the framing is right: the modifiers describe the same live video visit, and the payer decides which one belongs on the claim. Modifier 95 is the modern default for Medicare professional claims and most commercial payers. GT holds its remaining ground in state Medicaid programs, CAH Method II institutional billing, and legacy contracts. GQ covers asynchronous care, 93 covers audio-only, and the POS code carries the rest of the telehealth signal.

Key takeaways:

Default to modifier 95 for Medicare professional claims and most commercial payers.
Keep GT in the workflow for Medicaid plans and institutional scenarios that require it.
Never stack GT and 95 on the same line without explicit payer instruction.
Use GQ only for store-and-forward services and 93 for covered audio-only visits.
Pair every telehealth modifier with the correct POS code, 10 for home and 02 for other locations.
Maintain a payer-specific modifier matrix so the choice is a lookup, not a guess.

Telehealth billing rewards teams that treat modifier selection as a payer-driven process. Get the matrix right once, and the denials largely take care of themselves.