What is a GT Modifier?

A GT modifier is a code used in medical billing to show that a service was provided through telemedicine.
Telemedicine, also known as telehealth, is remote medical care.
Telemedicine uses telecommunications technology - such as phone calls, video conferences, and other platforms - to provide services.
Using telemedicine allows patients to be assessed, diagnosed, and treated by healthcare professionals all from the comfort of their own home…or maybe their car, or place of work, or just about practically anywhere! (all in the right setting situations of course and if you have access to internet service).
Telemedicine is used and valued significantly in the healthcare industry.
During COVID-19 we saw an exponential rise in the number of telemedicine appointments. It’s been a little bit of time since the peak of the pandemic but we are still seeing an increase in the usage of telemedicine or telehealth.
Remote clinical care is not the only benefit of telehealth.
It offers remote monitoring, patient education, administrative services, and provider collaboration.
Telehealth does it all.
A survey conducted by the American Medical Association shares with us that physicians have “enthusiastically” embraced telehealth and are expecting an increase of usage in it in the future.
Statistics from that survey show:
Around 85% of physicians are currently using telehealth to care for their patients.
Around 70% report that their organization is motivated to continue using telehealth in their practice.
It’s safe to say that telemedicine isn’t going anywhere anytime soon.
Which brings us back to our topic of “What is a GT modifier?”
Healthcare providers must understand correct billing practices in regards to telemedicine in order to ensure accurate and timely payment for their services.
Telemedicine billing requires a modifier which helps distinguish a telehealth visit from an in-person visit.
In the world of medical coding, the GT modifier renders as "Via Interactive Audio and Video Telecommunications Systems". It’s used to indicate that a service has been provided via telecommunication technology, such as video conferencing, rather than in-person.
The GT modifier is commonly paired to a CPT code.
A CPT code is a Current Procedural Terminology code to describe medical procedures and services.
The GT modifier + the appropriate CPT code = accurate billing and reimbursement for services!
The use of telemedicine and associated modifiers may vary based on payer guidelines.
It's crucial for healthcare providers to understand and follow the specific rules and requirements of the payer they are dealing with.
The GT modifier is applied to services that would normally be in person but are taking place remotely through telemedicine.
Some examples of when the GT modifier would apply are:
Telemedicine services such as a virtual check-up or appointment, remote monitoring services for on-going care, teleconsultations, behavioral health services, and second opinions via a specialist.
Two things to take into consideration if you are contemplating when to use the GT modifier are (1) the specific needs of the patient and (2) the type of care that is being provided to them.
It’s essential as a healthcare provider to be aware that specific billing requirements for telemedicine guidelines may vary from state to state.
The Centers for Medicare & Medicaid Services, CMS, has guidelines and regulations concerning the use of GT modifiers for further information.
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