How the list works
Section 1834(m) of the Social Security Act limits Medicare telehealth to services on a list that CMS maintains through the annual Physician Fee Schedule rulemaking. Each year CMS reviews requests to add services, assigns the ones it accepts to the list on a permanent or provisional basis, and removes services whose provisional status lapsed without evidence of clinical benefit. A code on the list is paid at the same rate as the in-person service when the claim meets the originating site, distant site practitioner, modality and documentation rules; a code that is not on the list is not a Medicare telehealth service regardless of how it was delivered, and the claim should be billed as the in-person service only when the service was actually furnished in person. The list does not itself cover communication technology-based services such as virtual check-ins, e-visits and remote monitoring, which are separate benefits with their own codes and are not subject to the telehealth restrictions.
Two sets of rules sit on top of the list. The permanent statutory rules allow telehealth for mental health and substance use disorder services furnished to a patient at home, including audio-only when the patient cannot or will not use video, and remove the geographic restriction for those services, for home dialysis monthly visits and for acute stroke evaluation. The pandemic-era flexibilities that extended the home as an originating site and lifted the geographic restriction for every other service on the list have been continued by Congress through a series of short-term extensions, and the expiration date in force on the date of service decides whether a non-behavioral telehealth claim from a patient's home is payable. Check the current extension in the CMS telehealth guidance before relying on it for scheduling or budgeting.
Place of service and modifiers
The place of service sets the payment rate and the modifier states the modality; the two must agree with each other and with the code's eligibility on the list.
| Code | When to use it | Payment effect |
|---|---|---|
| POS 10 | Patient is at home at the time of the service | Paid at the non-facility PFS rate |
| POS 02 | Patient is at any location other than home, for example a clinic, a hospital outpatient department or a skilled nursing facility | Paid at the facility PFS rate |
| Modifier 95 | Synchronous, real-time audio and video | Confirms the modality; required by many Medicare Advantage and commercial payers, accepted by Medicare |
| Modifier 93 | Service furnished by audio only, where the code and the policy allow audio-only delivery | Identifies audio-only; payer policy decides whether the code is payable without video |
| Modifier FQ | Audio-only mental health or substance use service to a patient at home | Required by Medicare on those claims together with the home place of service |
| Modifier GT | Critical access hospital method II telehealth claims | Institutional claims only; replaced by the place-of-service code on professional claims |
| Modifier GQ | Asynchronous store-and-forward telehealth in the federal Alaska and Hawaii demonstration programs | Limited to those demonstrations |
HCPCS Level II codes on the 2026 list
G codes carry the Medicare-specific services such as annual wellness visits, chronic care management, behavioral health integration and the ESRD monthly visits; the descriptors are the CMS short descriptors from the list.
| Code | Short descriptor | 2026 status |
|---|---|---|
| G0011 | Ind couns for PrEP by QHP, 15-30 min | Maintain |
| G0013 | Initial or contd couns for PrEP by clinical staff, 30 min | Maintain |
| G0108 | Diab manage trn per indiv | Maintain |
| G0109 | Diab manage trn ind/group | Maintain |
| G0136 | Admin PA/N risk assmt tool, 5-15 min | Maintain |
| G0270 | Mnt subs tx for change dx | Maintain |
| G0296 | Visit to determ ldct elig | Maintain |
| G0316 | Prolonged hospital inpatient or observation care | Maintain |
| G0317 | Prolonged nursing facility evaluation and management service | Maintain |
| G0318 | Prolonged home or residence evaluation and management | Maintain |
| G0396 | Alcohol/subs interv 15-30mn | Maintain |
| G0397 | Alcohol/subs interv >30 min | Maintain |
| G0406 | Inpt/tele follow up 15 | Maintain |
| G0407 | Inpt/tele follow up 25 | Maintain |
| G0408 | Inpt/tele follow up 35 | Maintain |
| G0410 | Grp psych partial hosp 45-50 | Maintain |
| G0420 | Ed svc ckd ind per session | Maintain |
| G0421 | Ed svc ckd grp per session | Maintain |
| G0422 | Intens cardiac rehab w/exerc | Maintain |
| G0423 | Intens cardiac rehab no exer | Maintain |
| G0425 | Inpt/ed teleconsult30 | Maintain |
| G0426 | Inpt/ed teleconsult50 | Maintain |
| G0427 | Inpt/ed teleconsult70 | Maintain |
| G0438 | Ppps, initial visit | Maintain |
| G0439 | Ppps, subseq visit | Maintain |
| G0442 | Annual alcohol screen 15 min | Maintain |
| G0443 | Brief alcohol misuse counsel | Maintain |
| G0444 | Depression screen annual | Maintain |
| G0445 | High inten beh couns std 30m | Maintain |
| G0446 | Intens behave ther cardio dx | Maintain |
| G0447 | Behavior counsel obesity 15m | Maintain |
| G0459 | Telehealth inpt pharm mgmt | Maintain |
| G0473 | Group behave couns 2-10 | Addition |
| G0506 | Comp asses care plan ccm svc | Maintain |
| G0508 | Crit care telehea consult 60 | Maintain |
| G0509 | Crit care telehea consult 50 | Maintain |
| G0513 | Prolong prev svcs, first 30m | Maintain |
| G0514 | Prolong prev svcs, addl 30m | Maintain |
| G0539 | Initial care training 30 mi | Maintain |
| G0540 | train for caregiver add 15 | Maintain |
| G0541 | no pt present train, initial 30 | Maintain |
| G0542 | Care train to pts face to face 15 m | Maintain |
| G0543 | Group train w/o patient | Maintain |
| G0545 | Inherent visit to inpt | Addition |
| G0560 | Safety plan interven | Maintain |
| G2086 | Off base opioid tx 70min | Maintain |
| G2087 | Off base opioid tx, 60 m | Maintain |
| G2088 | Off base opioid tx, add30 | Maintain |
| G2211 | Complex E/M visit add on | Maintain |
| G2212 | Prolong outpt/office vis | Maintain |
| G3002 | Chronic pain tx monthly b | Maintain |
| G3003 | Addition 15m pain mang | Maintain |
| G9685 | Acute nursing facility care | Maintain |
| HCPCS | Short Descriptor | Proposed Action |
CPT codes on the 2026 list, by number
230 CPT codes are on the list. They are reproduced as bare code numbers grouped by code range; the descriptor for any CPT code is available in the AMA CPT code book or a licensed encoder. Codes marked with an asterisk were added for 2026.
77xxx (1)
77427
90xxx (38)
90785 90791 90792 90832 90833 90834 90836 90837 90838 90839 90840 90845 90846 90847 90849* 90853 90875 90901 90951 90952 90953 90954 90955 90956 90957 90958 90959 90960 90961 90962 90963 90964 90965 90966 90967 90968 90969 90970
92xxx (37)
92002 92004 92012 92014 92507 92508 92521 92522 92523 92524 92526 92550 92552 92553 92555 92556 92557 92563 92565 92567 92568 92570 92587 92588 92601 92602 92603 92604 92607 92608 92609 92610 92622* 92623* 92625 92626 92627
93xxx (3)
93750 93797 93798
94xxx (7)
94002 94003 94004 94005 94625 94626 94664
95xxx (5)
95970 95971 95972 95983 95984
96xxx (29)
96105 96110 96112 96113 96116 96121 96125 96127 96130 96131 96132 96133 96136 96137 96138 96139 96156 96158 96159 96160 96161 96164 96165 96167 96168 96170 96171 96202 96203
97xxx (37)
97110 97112 97116 97129 97130 97150 97151 97152 97153 97154 97155 97156 97157 97158 97161 97162 97163 97164 97165 97166 97167 97168 97530 97535 97537 97542 97550 97551 97552 97750 97755 97760 97761 97763 97802 97803 97804
98xxx (6)
98960 98961 98962 98966 98967 98968
99xxx (62)
99202 99203 99204 99205 99211 99212 99213 99214 99215 99221 99222 99223 99231 99232 99233 99234 99235 99236 99238 99239 99281 99282 99283 99284 99285 99291 99292 99304 99305 99306 99307 99308 99309 99310 99315 99316 99341 99342 99344 99345 99347 99348 99349 99350 99406 99407 99468 99469 99471 99472 99473 99475 99476 99477 99478 99479 99480 99483 99495 99496 99497 99498
Category III (xxxxT) (5)
0362T 0373T 0591T 0592T 0593T
Added for 2026
New codes take effect for dates of service on or after January 1, 2026; claims for these services before that date are not telehealth services under Medicare.
| Code | Descriptor | Code system |
|---|---|---|
| 90849 | CPT descriptor not reproduced (AMA licence) | CPT |
| 92622 | CPT descriptor not reproduced (AMA licence) | CPT |
| 92623 | CPT descriptor not reproduced (AMA licence) | CPT |
| G0473 | Group behave couns 2-10 | HCPCS Level II |
| G0545 | Inherent visit to inpt | HCPCS Level II |
How telehealth claims deny
Most telehealth denials are structural rather than clinical. A code that is not on this list returns claim adjustment reason code CARC 5, procedure code inconsistent with the place of service, when it is billed with POS 02 or 10; a code billed with a modifier the payer does not accept for that modality returns reason code 4, procedure code inconsistent with the modifier used. Audio-only behavioral health claims without the FQ modifier, home-based claims billed with POS 02, and services whose provisional status expired at the start of the year are the three patterns that show up most often in denial work queues in January. The remaining denials are the same as for the in-person service: frequency limits, which the MUE lookup shows per code, and medical necessity under the contractor's coverage policies.
Frequently asked questions
Which codes can be billed as Medicare telehealth in 2026?
Only the codes on the CMS list of Medicare telehealth services for calendar year 2026, published with the Physician Fee Schedule final rule. This page reproduces that list in full; a service not on it cannot be billed to Medicare as telehealth even when it is furnished by video.
What place of service do I use for telehealth?
Place of service 10 when the patient is at home and 02 when the patient is anywhere else, such as a clinic or facility. Medicare pays POS 10 claims at the non-facility rate and POS 02 claims at the facility rate, so the choice changes the payment.
What is the difference between modifiers 95, 93 and FQ?
Modifier 95 identifies a synchronous audio and video service. Modifier 93 identifies a service furnished by audio only. FQ is the CMS modifier for audio-only mental health and substance use services furnished to a patient at home, and it is required on those claims in addition to the place-of-service code.
Why are CPT codes shown without descriptions?
CPT descriptors are copyrighted by the American Medical Association and QuickIntell does not hold a distribution license for public display. CPT codes appear as bare numbers; HCPCS Level II descriptors are public domain and are shown in full.
How do I know a telehealth claim denied for place of service or modifier?
Claim adjustment reason code 5 says the procedure code is inconsistent with the place of service, and reason code 4 says it is inconsistent with the modifier used. Both point back to this list: either the code is not eligible for telehealth or the claim carried the wrong POS or modifier combination.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- List of Medicare telehealth services, calendar year 2026Version CY2026 PFS final rule list · effective 2026-01-01 · file CY 2026 PFS Final List of Medicare Telehealth Services.xlsxSHA-256 37a2639174aab141…
Disclaimer
Operational reference compiled from the CMS telehealth services list. Telehealth payment also depends on the statutory flexibilities in force on the date of service, the practitioner type and the payer. Not legal, clinical or billing advice.