What does the modifier code 95 represent in telehealth billing?

The modifier code 95 is specifically used to indicate that a service was provided through synchronous telehealth technologies. This means that the service was delivered during real-time, interactive communication between the patient and provider, allowing for a more dynamic and immediate exchange akin to in-person visits.

Using the 95 modifier is essential for proper billing and reimbursement for telehealth services, as it ensures that payers recognize the service as being conducted through telecommunication technologies, complying with regulatory requirements and standards for telehealth practices.

The other options relate to different aspects of healthcare billing and coding. For example, place of service codes define where the service was provided, which may or may not pertain directly to the delivery method like telehealth. Meanwhile, insurance verification covers the process of confirming patient insurance benefits and eligibility, while specialty codes categorize the type of services based on the practitioner's specialty. Understanding the role of the 95 modifier is crucial for accurately indicating that a service was delivered via synchronous telehealth, rather than being categorized under other billing aspects.