RE: Updated Billing Changes to the Telehealth Audio-Only Modifier Use for OMH-Licensed/Designated Outpatient Programs Grid and Audio-Only Modifier Change

TO: BEHAVIORAL HEALTH PROVIDERS

IMPACTED PLANS: Medicaid, HIV SNP, HARP, and MAP

Dear MetroPlusHealth Provider,

Effective July 1, 2025, OMH providers should use modifier “93” for eligible telehealth audio-only mental health services. Please refer to this updated Telehealth Modifier Use for OMH-Licensed/Designated Outpatient Programs Grid (Telehealth Grid) for a full and comprehensive list of eligible audio only mental health services. This change is made to align with the CMS billing practices to streamline crossover claims processing between Medicare and Medicaid.

Important Note:

Although Modifier “FQ” is no longer being used for mental health services provided via telehealth audio-only, there may-be other billing scenarios where “FQ” may be accepted as an appropriate modifier.
Please refer to Telehealth Updates | MetroPlusHealth for more information.

If you have any questions regarding this memo, please contact MetroPlusHealth at: [email protected].

Thank you.

MetroPlusHealth

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last updated: June 10, 2025

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