Is G0513 covered for telehealth? (Medicare)
G0513 (Prolong prev svcs, first 30m) appears on Medicare's list of covered telehealth services. This means Medicare may reimburse this code when furnished via telehealth, provided the encounter meets all standard requirements for the underlying service it extends.
How to bill it
Bill G0513 with the place-of-service code that matches where the patient was located: POS 02 or POS 10, depending on whether the patient was outside or inside their home. Append modifier 95 to indicate the service was delivered via an interactive audio-video telecommunications system. POS reference → · modifier reference →
Audio-only
Medicare's list of telehealth services doesn't specify audio-only eligibility for this code. Audio-only is permitted for a number of services (notably behavioral and mental-health care); confirm against current CMS guidance and your payer before billing audio-only.
Frequently asked
When should I use POS 02 versus POS 10 for G0513?
Use POS 02 if the patient was located somewhere other than their home (e.g., a facility) at the time of the telehealth encounter, and POS 10 if the patient was in their own home. The correct POS reflects patient location, not provider location.
Does commercial or Medicaid coverage for G0513 match Medicare's rules?
Not necessarily. This reference reflects Medicare telehealth policy only; commercial payers and state Medicaid programs may have different coverage, POS, or modifier requirements, so verify with each payer separately.
Is modifier 95 required every time G0513 is billed via telehealth?
Per the guidance shown here, modifier 95 is the modifier associated with this code for telehealth billing. Always cross-check current CMS and payer-specific instructions, since modifier requirements can be updated.
More free billing tools: all telehealth codes · telehealth checker · Medicare fee for G0513 · place of service · modifiers
Reflects Medicare's list of telehealth services for this year; audio-only, POS and modifier rules can change. Commercial and Medicaid telehealth coverage differ — verify current CMS guidance and your payer's rules before billing.
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