The difference between modifier 95 and GT for telehealth claims, and when each one is required.
Telehealth modifiers exist to tell a payer that a service, normally delivered in person, was instead delivered via audio-video technology. Two modifiers dominate this space — 95 and GT — and payer-specific preference between them is one of the more common sources of avoidable telehealth denials.
Modifier 95
Modifier 95 indicates a synchronous telemedicine service delivered via real-time audio and video communication. It's the more widely used of the two across commercial payers and has become the default expectation in many payer policies.
Modifier GT
Modifier GT historically indicated a similar synchronous telehealth service, primarily used in Medicare and some Medicaid billing contexts. Its usage has narrowed over time as more payers have standardized around modifier 95, but some regional and government payers still require it specifically.
Why Getting This Wrong Causes Denials
Submitting the wrong modifier for a given payer doesn't always draw a straightforward "wrong modifier" denial — it often shows up as an outright rejection for a service the payer says isn't covered, which can be misleading during a first review. This is part of why our broader [telehealth billing guide](/blog/telehealth-billing-obgyn-2026) recommends verifying payer-specific requirements before submission rather than defaulting to one modifier across the board.
Building a Payer Modifier Reference
The most effective long-term fix is a simple internal reference sheet listing each contracted payer and their required telehealth modifier, place-of-service code, and any visit-type restrictions. This turns a recurring judgment call into a lookup.
Key Takeaways
- ›Modifier 95 and GT are not interchangeable — payer preference varies
- ›Wrong-modifier denials often look like coverage denials at first glance
- ›A payer-specific modifier reference sheet prevents repeat errors
Our full [CPT code library](/resources/cpt-library) includes modifier guidance alongside procedure codes for exactly this kind of quick reference during claim submission.