Is G0542 covered for telehealth? (Medicare)
G0542 appears on Medicare's list of approved telehealth services, meaning it can be billed as a telehealth encounter when furnished via an interactive audio-video system under Medicare's telehealth rules. Coverage on this list does not guarantee payment on every claim — documentation, medical necessity, and payer-specific rules still apply.
How to bill it
For Medicare, report G0542 with place of service 02 (telehealth provided somewhere other than the patient's home) or 10 (telehealth provided in the patient's home), matching where the patient was located during the visit. Append modifier 95 to indicate the service was delivered via telehealth. 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
What's the difference between POS 02 and POS 10 for G0542?
POS 02 is used when the patient is located somewhere other than their home (e.g., a facility) during the telehealth visit, while POS 10 is used when the patient is at home. Choose the code that reflects the patient's actual location at the time of service.
Does commercial or Medicaid coverage follow the same rules as Medicare for G0542?
No. This guidance reflects Medicare's telehealth policy only. Commercial payers and state Medicaid programs may have different POS, modifier, or audio-only requirements for G0542, so always confirm with the specific payer before billing.
Is modifier 95 always required for G0542 telehealth claims?
For Medicare, modifier 95 is the guidance associated with this code to indicate telehealth delivery. Confirm current modifier requirements with CMS and the applicable Medicare Administrative Contractor, since instructions can be updated.
More free billing tools: all telehealth codes · telehealth checker · Medicare fee for G0542 · 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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