Modifier -95: Synchronous Telemedicine Service via Real-Time Interactive Audio and Video

Quick reference

What it signals: Append -95 to the CPT code to indicate the service was rendered synchronously via real-time interactive audio and video telecommunications — i.e., a live two-way video visit.
Audio-video only: -95 is specifically for audio AND video visits. Audio-only synchronous services use modifier -93 instead.
Medicare still requires it: Beginning January 1, 2025, most commercial payer and CPT guidelines no longer require -95 because new telemedicine CPT code descriptors identify the modality — but Medicare Part B still requires -95 on applicable claims.

New 2025 telemedicine CPT codes: CMS adopted new telemedicine-specific CPT codes (98000-98015 and add-on 99417) effective January 1, 2025. For Medicare synchronous audio-video E/M visits, these codes are reported with -95 and the appropriate place of service.
Legacy E/M codes still used with -95: For Medicare, office/outpatient E/M codes (99202-99205, 99212-99215) reported via telehealth continue to require -95 for audio-video encounters.
Place of Service (POS): CMS requires POS 02 (telehealth) for most Medicare telehealth claims, or POS 10 (telehealth provided in patient’s home) when the patient is in their home at the time of service.
Originating site rules: For Medicare, the patient must generally be at an approved originating site, though COVID-era waivers extended flexibility; confirm current waiver status as extensions have varied year to year.
-FQ vs -95: -FQ is used when the service was furnished using real-time audio-only communication under a Medicare telehealth waiver; -95 is for audio-video. Do not conflate the two.

Modality documented: The note must state that the encounter was conducted via live, two-way interactive audio and video (e.g., “Visit conducted via synchronous video telehealth platform.”).
Patient location noted: Document where the patient was located at the time of service (home, established patient location, etc.) to support the POS code used.
Same E/M documentation standards apply: MDM or time must be documented to the same standard as an in-person visit — telehealth does not lower the bar for E/M level selection.
Consent: Many state laws and payer policies require documented patient consent for telehealth services, especially at the outset of a telehealth relationship.

Office/Outpatient E/M: -95 on 99202, 99203, 99204, 99205 (new) or 99212, 99213, 99214, 99215 (established) for Medicare.
New 2025 telemedicine codes (audio-video, new patient): 98000, 98001, 98002, 98003 with -95.
New 2025 telemedicine codes (audio-video, established patient): 98004, 98005, 98006, 98007 with -95.
Add-on code: 99417 for prolonged services 75+ minutes, reported with -95.
Behavioral health: Many behavioral health CPT codes (90832-90838, 90847, etc.) are on the Medicare telehealth list and may be billed with -95.
Speech therapy via telehealth: 92507 billed with -95 for synchronous SLP telehealth sessions (plus -GN for Medicare).

Medicare: Requires -95 on all synchronous audio-video telehealth claims; pair with POS 02 or POS 10 as appropriate.
Commercial (BCBS, UHC, Cigna, Aetna): As of 2025, many commercial payers no longer require -95 because new CPT code descriptors identify the modality. Verify individual payer policy annually.
Modifier stacking example: A Medicare established patient speech therapy telehealth visit = 92507 + -95 + -GN (SLP plan of care required for Medicare).

Was the encounter conducted via live, two-way audio AND video (not audio-only)?
Is this a Medicare claim? (Commercial payers may not require -95 as of 2025.)
Is the CPT code on the Medicare telehealth approved code list?
Is POS 02 or 10 selected correctly based on patient location?