Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim lines when the encounter was delivered through an interactive audiovisual telecommunications system (synchronous telemedicine). For Medicare and many outpatient therapy providers (e.g., audiology, SLP), guidance directs using the CPT code that would have been reported for an in‑person visit and appending modifier 95 to show telehealth delivery ([AAPC]; CMS Noridian).

How you report place of service (POS) together with modifier 95 affects payment. Medicare COVID‑19 and specialty guidance (ASHA, audiology) instructs keeping the POS that reflects where the service would have been provided in‑person (for example POS 11 for office) while appending modifier 95—this preserves nonfacility reimbursement rather than triggering lower facility rates. Commercial payer practice varies: the AMA Telehealth Implementation Playbook notes many commercial plans commonly pair modifier 95 with POS 02, so always confirm payer rules before billing.

In practice: outpatient SLP or audiology telehealth visits are typically billed with the usual CPT code, POS 11, and modifier 95 so Medicare reimburses at the nonfacility rate; primary care or other commercial telehealth encounters often use the usual CPT code, POS 02, and modifier 95 per payer policy. Because payer conventions differ and policies evolve, always verify current Medicare and commercial payer instructions when submitting telehealth claims.