Telemedicine and virtual services

Applies to:

Commercial group HMO, EPO, POS and PPO plans
Commercial individual MyPriority® plans
Priority Health Choice plans (Medicaid and Healthy Michigan Plan)
Priority Health Medicare plans

Medical policy

Telemedicine - 91604

Telemedicine billing

Place of service codes

Professional providers: report the place of service (POS) code as if the member was seen in person, along with the appropriate modifier below to indicate the virtual care method used:

  • 95: Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System
  • 93: Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
  • GT: Via interactive audio and video telecommunication systems
  • GQ: Via asynchronous telecommunications system

Reference our Telemedicine medical policy (#91604) which outlines how our commercial and individual / ACA plans adhere to the list of services defined for synchronous and asynchronous telehealth services.

We follow the telehealth guidelines defined by CMS and MDHHS for Medicare and Medicaid respectively:

Service-specific pages