Is G9685 covered for telehealth? (Medicare)
G9685 (Acute nursing facility care) appears on Medicare's list of approved telehealth services, meaning Medicare will consider payment when the service is furnished via telehealth under Medicare's telehealth rules. Coverage and billing rules can change, so always confirm current status against the latest CMS telehealth list before submitting a claim.
How to bill it
Report G9685 with place-of-service 02 or 10, depending on where the patient is located during the visit, and append modifier 95 to indicate the service was furnished via telehealth. Make sure the POS code matches the patient's actual location (non-facility home setting vs. other originating site) to avoid mismatches with the telehealth claim. 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 G9685?
POS 02 generally indicates the patient was at a telehealth originating site other than home, while POS 10 indicates the patient was at home. Select the code that reflects the patient's actual location during the encounter.
Does this Medicare coverage apply to commercial or Medicaid plans too?
No. This reference reflects Medicare's telehealth list only. Commercial payers and state Medicaid programs may have different covered codes, POS requirements, or modifier rules, so verify each payer's policy separately.
Is modifier 95 required every time G9685 is billed via telehealth?
Per the modifier guidance shown, modifier 95 should be appended when billing this code as a telehealth service. Omitting it may cause the claim to be processed as an in-person service or be rejected.
More free billing tools: all telehealth codes · telehealth checker · Medicare fee for G9685 · 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.
Run telehealth the easy way
CareNiva pairs these free tools with HIPAA-compliant video visits, intake, and an AI scribe. Start free — ready in minutes.
100% Satisfaction Guaranteed — try it risk-free