Updated November 2021
The resources created for the AAOS website regarding virtual visits with interactive electronic communication between a patient and physician are referred to by both Telehealth and Telemedicine terminology. This is because the Centers for Medicare and Medicaid Services (CMS) refers to virtual synchronous visits as Telehealth, and all HCPCS Level II codes (created by CMS) or specific policy from CMS uses the term Telehealth. The Current Procedural Terminology (CPT) code set uses the term Telemedicine for all codes, descriptors and modifiers. These terms may be used interchangeably.
The following CPT definition for Telemedicine codes is listed in Appendix P of the CPT code book:
“This listing is a summary of CPT codes that may be used for reporting synchronous (real-time) telemedicine services when appended by modifier 95. Procedures on this list involve electronic communication using interactive telecommunications equipment that includes, at a minimum, audio and video. The codes listed below are identified in CPT 2021 with the ★ symbol.”
The following is the Modifier 95 definition for Telemedicine services:
“Modifier 95, Synchronous Telemedicine Service Rendered Via a Real- Time Interactive Audio and Video Telecommunications System: Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. Modifier 95 may only be appended to the services listed in Appendix P. Appendix P is the list of CPT codes for services that are typically performed faceto-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.”