Making Sense of Audio Only CPT Code and Their Modifiers – Telehealth.org

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Given the official ambiguity about the official termination of the COVID-related Public Health Emergency (PHE), it may be time to discuss using the “FQ” telephone CPT code and available resources for provider groups and individuals delivering telephone-based services. Some of the key facts include the following:The FQ modifier code was approved in 2022 for when…

Given the official ambiguity about the official termination of the COVID-related Public Health Emergency (PHE), it may be time to discuss using the “FQ” telephone CPT code and available resources for provider groups and individuals delivering telephone-based services. Some of the key facts include the following:

  • The FQ modifier code was approved in 2022 for when a service is rendered using audio-only technology. The technology allows for two-way, real-time communication behavioral health services (counseling and therapy),1 although it was reportedly effective 1-1-2022.
  • However, providers are not allowed to bill using this code until after the end of the PHE, as per the WPS Government Health Administrators (WPSGHA) publication of the Modifier FQ Fact Sheet.
  • The use of the new code appears to have been postponed until the end of the PHE for many providers.
  • However, it is worthy of note that some private insurers, such as  OPTUM of Alaska, began requiring the use of the FQ audio-only modifier code in April of 2022.

What Is the Difference Between CPT Procedure Codes and Modifier Codes?

CPT (Current Procedural Terminology) codes are the foundational elements of a worldwide diagnostic and procedure coding system for reimbursement of healthcare services based on the International Classification of Diseases, 10th Revision (ICD-10). This was endorsed by the World Health Organization (WHO) in 1990 and adopted in the United States on October 1, 2015. These distinctions may help:

  • CPT Codes. Five-digit CPT codes correspond to the type of service supplied or action taken by licensed professionals. For example, the code 90834 corresponds to “Psychotherapy. 45 minutes.” 
  • Modifier Codes. CPT modifiers provide extra details concerning a procedure or service without changing the definition of the CPT code. In the case of the FQ code, the 90843 would be augmented to read: 90843-FQ to signify that the psychotherapy…

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