In today’s rapidly evolving healthcare ecosystem, telehealth continues to play a transformative role in making care more accessible, convenient, and patient-centered. While video-based telemedicine became the standard during the COVID-19 pandemic, audio-only telehealth services emerged as a crucial alternative for patients without access to smartphones, stable internet, or devices capable of video connectivity. To support accurate documentation and reimbursement of these encounters, CMS introduced modifier FQ, specifically for audio-only telehealth services.
For healthcare organizations navigating the complexity of remote care billing, understanding the correct usage of the FQ modifier is critical. Incorrect modifier assignment can result in denied claims, reduced reimbursement, and compliance issues. That’s where Allzone Management Services supports providers with expert billing, coding, and telehealth reimbursement solutions to maintain accuracy every step of the way.
What Is Modifier FQ?
Modifier FQ is used to identify audio-only telehealth services during a patient encounter. It tells the payer that the service was delivered via a telecommunication system that did not include video, but still met all clinical standards for remote care.
CMS introduced the modifier to differentiate audio-only services from video telehealth. While many services previously required both audio and video components, CMS expanded coverage to include audio-only options, particularly for behavioral health, evaluation, and certain outpatient visits. Using modifier FQ helps ensure transparent reporting and proper payment for these services.
Why Audio-Only Telehealth Matters
Despite advancements in digital health technology, not all patients have equal access to video-based telemedicine. Many face barriers such as:
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- Limited broadband connectivity
- Lack of smartphones or computer devices
- Technical challenges with video applications
- Age-related constraints
- Physical impairments
For these patients, audio-only telehealth ensures continuity of care, especially for routine check-ins, medication management, chronic care coordination, and behavioral health support. Modifier FQ enables providers to capture and bill these encounters ethically and compliantly.
When Should Modifier FQ Be Used?
Modifier FQ should be appended when the telehealth service was delivered strictly via audio-only communication, without any video interaction. It applies when:
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- The provider uses a telephone or another audio communication platform.
- The service meets CMS or payer requirements for audio-only coverage.
- The service is clinically appropriate to be delivered through audio.
- Documentation clearly supports the use of audio-only communication.
The modifier is widely used in behavioral health services, but its application extends to many other E/M services depending on payer policies.
Common services where modifier FQ may apply include:
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- Behavioral health counseling
- Mental health and psychiatric evaluations
- Chronic care management discussions
- Follow-up consultations
- Brief check-in visits
- Certain E/M visits when allowable by the payer
Correct use of modifier FQ ensures compliance and eliminates ambiguity in how the telehealth encounter was conducted.
Difference Between FQ and Other Telehealth Modifiers
Understanding how FQ compares with other popular telehealth modifiers helps avoid confusion:
Modifier FQ
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- Audio-only telehealth service
- No video component involved
Modifier 95
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- Synchronous audio-video telehealth services
- Service delivered in real-time with both audio and visual components
Modifier FR
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- Identifies supervisory services conducted via telehealth
Modifier FT
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- Used when services are furnished due to pandemic-related waivers or disruptions
Each modifier serves a unique purpose. Using them accurately prevents reimbursement delays and ensures payers receive clear information.
Documentation Requirements for Modifier FQ
Documentation is the backbone of compliant telehealth billing. When using FQ, providers must ensure that the medical record includes:
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- Statement that the visit was conducted via audio-only
- Reason why audio-only communication was clinically appropriate
- Patient consent for telehealth
- Details of the encounter, including history, discussion, assessments, and treatment plans
- Duration of the call when applicable
- Patient’s location during the call
- Provider’s location, if required by payer guidelines
Improper or insufficient documentation may lead to claim denials—even when the FQ modifier is correctly appended.
Challenges Providers Face with Audio-Only Telehealth Billing
Despite its convenience for patients, billing for audio-only services presents several obstacles:
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- Complex and frequently changing payer rules
- Lack of uniform policies across commercial payers
- Confusion over whether certain codes qualify for audio-only reimbursement
- Documentation inconsistencies
- Incorrect use of modifiers FQ and 95
- Risk of audits if encounters are not properly supported
These challenges can strain internal billing teams, reduce operational efficiency, and affect revenue integrity.
How Allzone Helps Providers with Modifier FQ and Telehealth Billing
As a leading provider of end-to-end medical billing services, Allzone Management Services helps healthcare organizations streamline telehealth billing processes, reduce denials, and improve cash flow. Our experienced coders and billing experts stay up to date with constantly evolving telehealth regulations and ensure accurate modifier usage, including FQ.
Allzone’s Telehealth Billing Expertise Includes:
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- Correct assignment of telehealth modifiers (FQ, 95, GT, FR, etc.)
- Verification of payer-specific rules for audio-only services
- Accurate claim submission with proper coding guidelines
- Comprehensive documentation audits
- Compliance-driven billing workflows
- Denial prevention and resolution strategies
- Weekly updates on telehealth reimbursement trends
- Seamless integration with EHR and practice management systems
By partnering with Allzone, providers can focus on delivering quality care while we ensure every telehealth encounter—including audio-only visits—is captured and reimbursed correctly.
Why Accurate Modifier Usage Matters
The future of telehealth is expanding, and audio-only telehealth is proving to be an essential component of remote care. Precise modifier usage is crucial for:
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- Ensuring ethical billing
- Preventing claim rejections
- Supporting payer audits
- Maintaining regulatory compliance
- Optimizing revenue cycle performance
Modifier FQ, though simple, plays a substantial role in how providers communicate care delivery methods to payers. Inaccurate use can cause denied claims, compliance risks, and revenue leakage—issues that Allzone helps providers avoid.
Conclusion
Audio-only telehealth services have become a vital option for many patients, and modifier FQ ensures these services are billed transparently and compliantly. With payer guidelines constantly changing, accurate reporting requires deep expertise in telehealth billing, coding, documentation, and regulatory compliance.
Allzone Management Services empowers healthcare providers to navigate the complexities of remote care billing effortlessly. By ensuring correct use of modifier FQ and other telehealth modifiers, we help practices maximize reimbursement, enhance compliance, and strengthen financial performance.
If your practice offers audio-only telehealth services, partnering with Allzone can ensure your claims are processed accurately the first time—every time.