Therapy Billing Modifier Codes
Modifier codes are two-character alphanumeric codes appended to CPT codes on superbills and insurance claims to provide additional context about the service rendered. Selecting the correct modifier is essential for accurate reimbursement — especially for telehealth, same-day services, and credential-specific billing. Browse all 15 therapy-relevant modifiers below.
Synchronous telemedicine service
Append modifier 95 when the therapy session is delivered via real-time audio-video technology (e.
Via interactive audio and video telecommunication systems
Use modifier GT for Medicare and certain Medicaid telehealth claims delivered via two-way, real-time interactive audio-video systems.
Master's degree level
Append modifier HO when the rendering provider holds a master's degree and the payer requires credential-level billing distinctions.
Separate encounter — distinct service on the same day
Use modifier XE when two services are provided in separate, distinct encounters on the same calendar day and need to be differentiated on the claim.
Separate structure — distinct service on a different organ or structure
Apply modifier XS when two services are performed on separate anatomical structures or organ systems during the same visit and require individual identification on the claim.
Distinct procedural service
Append modifier 59 when a procedure or service is distinct from another service billed on the same day, and would otherwise be considered bundled or excluded from separate payment.
Significant, separately identifiable E/M service on the same day as a procedure
Use modifier 25 when a significant, separately identifiable evaluation and management (E/M) service is performed by the same provider on the same day as a procedure.
Repeat procedure by same physician
Apply modifier 76 when the same procedure is repeated by the same provider on the same day and needs to be identified as a repeat service on the claim.
Repeat procedure by another physician
Use modifier 77 when a repeat procedure is performed by a different provider than the one who originally performed it, on the same date of service.
Catastrophe/disaster related
Append modifier CR when services are related to a declared catastrophe or national disaster, such as a FEMA-declared emergency or a public health emergency.
Service furnished using audio-only telecommunications technology
Use modifier FQ when a behavioral health service is furnished using audio-only (telephone) telecommunications — meaning without video.
Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system
Append modifier 93 to claims for behavioral health services delivered via real-time audio-only telephone when the patient cannot or does not consent to video.
Bachelor's degree level
Apply modifier HN when the rendering provider holds a bachelor's degree and the payer requires credential-level billing distinctions.
Doctoral level
Use modifier HP when the rendering provider holds a doctoral degree (PhD, PsyD, EdD, MD, DO) and the payer distinguishes reimbursement by credential level.
Nurse practitioner rendering service in collaboration with physician
Append modifier SA when a nurse practitioner (NP) is the rendering provider and the service is performed in collaboration with or under the supervision of a physician.
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