Telehealth has transformed modern healthcare delivery, offering patients convenient access to care while helping providers expand their reach beyond physical clinic walls. As virtual visits grow, correct medical billing becomes more important than ever—especially when it comes to using telehealth-specific modifiers like Modifier GT.
For healthcare organizations, an incorrect modifier can quickly lead to claim denials, delayed reimbursements, compliance risks, and frustrated patients. This is why many providers are partnering with experts like Allzone Management Services to ensure accuracy, efficiency, and compliance in telehealth billing.
This blog explores the purpose of Modifier GT, when and how to use it correctly, common billing challenges, and how outsourcing telehealth billing to Allzone helps healthcare organizations streamline their revenue cycle with confidence.
What is Modifier GT?
Modifier GT is used to indicate that a healthcare service was delivered via interactive audio and video telecommunication systems. It signals to the payer that the encounter was conducted as a synchronous, real-time telehealth visit, not an asynchronous service or telephone-only consult.
Definition:
Modifier GT = “Via interactive audio and video telecommunications system.”
Before 2018, Medicare required Modifier GT on all telehealth claims. While Medicare transitioned to the place of service (POS) code system, many private payers, Medicaid programs, and commercial insurance carriers still require Modifier GT today.
When Should Modifier GT Be Used?
Modifier GT should be applied when:
- The provider and patient are interacting in real-time via audio + video.
- The service performed meets the criteria of an in-person visit.
- The payer specifically requires Modifier GT to reimburse telehealth services.
- The provider is delivering the same level of evaluation, diagnosis, or treatment virtually as would occur face-to-face.
Examples of CPT Codes Commonly Paired with Modifier GT
- Evaluation & Management (E/M) visits (e.g., 99201–99215)
- Psychiatric diagnostic evaluations
- Chronic care follow-up visits
- Follow-up consultations
- Telehealth therapy sessions
- Preventive counseling
- Remote nutrition counseling
Because telehealth requirements vary by payer, POS code, and provider type, correct application of Modifier GT is critical to avoid denials.
Modifier GT vs Modifier 95: What’s the Difference?
Many billers confuse Modifier GT with Modifier 95, but payers treat them differently.
| Feature | Modifier GT | Modifier 95 |
| Meaning | Interactive audio & video telecommunication | Synchronous telemedicine service |
| Used by | Commercial payers, Medicaid programs, certain private insurers | Broader use across telehealth services |
| Required by Medicare? | No, except for specific MA plans | Yes, often used for Medicare telehealth |
Key Point:
Some payers accept both modifiers—but many accept only one. Using the wrong modifier is one of the most common reasons for telehealth claim denials.
Why Modifier GT is Critical in Telehealth Billing
Telehealth billing comes with layers of payer-specific rules. Modifier GT plays a major role in:
1. Ensuring Proper Reimbursement: Payers can deny telehealth claims if the wrong modifier is used or if a required modifier is missing. Proper use of Modifier GT prevents underpayments and avoids unnecessary rework.
2. Preventing Compliance Issues: Incorrect telehealth documentation and coding may trigger compliance audits. Modifier GT indicates that the service meets real-time telehealth standards, helping providers stay aligned with payer policy.
3. Avoiding Claim Rejections: Telehealth claims are rejected at a much higher rate than in-person services due to changing rules. Using Modifier GT correctly reduces errors and supports cleaner claim submissions.
Challenges Healthcare Providers Face with Modifier GT
Despite being a simple two-character code, Modifier GT brings significant complexity because of the evolving and payer-specific telehealth billing landscape.
Common provider challenges include:
1. Payer Variations and Inconsistent Rules: What commercial insurance companies require for telehealth differs widely. Some require GT, others 95, and some require both based on POS codes or provider type.
2. Telehealth Documentation Requirements
Providers often fail to fully document telehealth encounters, including:
- Technology used
- Patient consent
- Real-time interactive communication
- Provider location and credentials
Missing information leads to denials—even when Modifier GT is used correctly.
3. Frequent Telehealth Policy Changes
Since COVID-19, telehealth billing rules have changed more frequently than any other area of healthcare billing. Practices struggle to keep up.
4. High Denial Rates
The most common reasons for GT-related denials include:
- Incorrect modifier
- Missing modifier
- Unsupported documentation
- Incompatible CPT + modifier pairing
- Payer does not recognize GT for the submitted service
This makes telehealth billing one of the easiest areas for revenue leakage.
Why Outsourcing Telehealth Billing to Allzone is the Smartest Choice
Telehealth billing is no longer a simple administrative task—it requires dedicated expertise. This is where Allzone Management Services adds enormous value.
1. 100% Accuracy in Modifier Usage
Allzone’s certified medical coders and billing specialists:
- Identify payer-specific telehealth requirements
- Apply Modifier GT, 95, and POS codes correctly
- Validate CPT/HCPCS compatibility
- Ensure compliance with Medicaid and commercial payer rules
This eliminates confusion and dramatically reduces denials.
2. Expertise in Telehealth-Specific Billing Rules
Allzone’s team stays updated with:
- CMS telehealth policies
- Commercial payer rule changes
- Medicaid telehealth updates
- State-specific telehealth mandates
Providers get accurate billing without needing to track constant rule changes.
3. Reduced Denials & Faster Payments
Telehealth claims are prone to denials—but with Allzone, the denial rate significantly drops due to:
- Pre-submission telehealth validation
- Proper modifier identification
- Clean claims with complete documentation
- Correct telehealth POS selection
This directly increases revenue and reduces A/R days.
4. Scalability and Cost Savings
Outsourcing telehealth billing to Allzone eliminates the cost and burden of:
- Hiring additional billing staff
- Training teams on new telehealth rules
- Investing in repeated audits
- Managing seasonal or sudden volume spikes
Allzone provides a scalable, cost-efficient solution.
5. Audit-Ready Documentation Support
Allzone ensures providers have complete and accurate documentation for each telehealth visit, including:
- Patient identity verification
- Consent documentation
- Interactive video confirmation
- Provider and patient location
This level of accuracy prevents compliance issues.
How Allzone Streamlines the Entire Telehealth Billing Workflow
Allzone offers an end-to-end telehealth billing solution designed for accuracy and speed:
- Verification of payer policies and telehealth eligibility
- Proper CPT and HCPCS code selection
- Correct application of Modifier GT and other telehealth modifiers
- Accurate POS coding
- Thorough documentation review
- Charge entry and claims submission
- Denial management for telehealth-specific denials
- Payment posting and ongoing reporting
This complete RCM support ensures that providers maximize reimbursement from every telehealth encounter.
Conclusion
Modifier GT plays a vital role in proper telehealth billing. As telehealth continues to expand, accurate and compliant billing is essential to avoid claim rejections, minimize revenue loss, and stay competitive. However, with constantly changing rules and payer-specific requirements, many providers struggle with telehealth billing complexity.
Outsourcing to Allzone Management Services ensures accurate modifier use, reduced denials, faster reimbursements, and complete compliance. Allzone’s expertise allows healthcare providers to focus on what matters most—delivering exceptional virtual care to patients.
If you want telehealth billing that is accurate, compliant, and optimized for maximum revenue, outsourcing to Allzone is the most reliable and cost-effective solution.