Is G0543 covered for telehealth? (Medicare)
G0543 (Group train w/o patient) appears on Medicare's list of approved telehealth services, meaning Medicare may reimburse this service when delivered via telehealth under current rules. Coverage status can change with each annual Medicare Physician Fee Schedule update, so billers should confirm the code is still active for the date of service.
How to bill it
For Medicare, bill G0543 with place of service 02 or 10, depending on whether the patient is located somewhere other than home (02) or in their home (10) at the time of the encounter. Append modifier 95 to indicate the service was furnished via an interactive audio and 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
What's the difference between POS 02 and POS 10 for G0543?
POS 02 indicates the patient received telehealth services from a location other than their home (e.g., another facility), while POS 10 indicates the patient was in their own home. Use the POS that matches the patient's actual location during the encounter.
Does modifier 95 apply the same way for all payers?
Modifier 95 usage shown here reflects Medicare guidance for G0543. Commercial payers and state Medicaid programs may have different modifier, POS, or telehealth eligibility rules, so verify each payer's specific policy before billing.
Is G0543 covered the same way under Medicaid or commercial insurance?
No. This reference reflects Medicare telehealth policy only. Medicaid and commercial telehealth coverage for G0543 can differ significantly in eligible POS, modifiers, and audio-only allowances, so check each payer's rules separately.
More free billing tools: all telehealth codes · telehealth checker · Medicare fee for G0543 · 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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