Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A for the 2022 cycle, effective January 1, 2022, with the descriptor: “Synchronous telemedicine service rendered via telephone or other real‑time interactive audio‑only telecommunications system.” Use when the live audio interaction between patient and qualified provider supplies the same substantive content as an in-person visit. ([ama-assn.org])

When billing, append -93 to the underlying CPT code to indicate audio-only synchronous telemedicine. Payer policies vary: some payers (including Medicare billing processes) require the modifier on claims for audio-only services and it may need to be combined with other provider-specific modifiers where applicable (for example, FQ for certain clinic types). In many contexts modifier 93 is descriptive only and does not itself change payment—the claim is adjudicated based on the underlying CPT code and the payer’s telehealth rules. ([telehealth.hhs.gov]; [lni.wa.gov])

Document the encounter to show medical necessity and that the service components meet the same requirements as an equivalent face-to-face or video visit. Practical examples include appending -93 to an E/M code (e.g., 99213-93 for a phone E/M visit) or to 96040 for audio-only genetic counseling that meets time unit rules. Because coverage and payment for audio-only services differ by payer, verify each payer’s policy before relying on reimbursement. ([cms.gov]; [perspectives.nsgc.org])