Email, Phone & Fax
A virtual check-in is a brief patient-initiated asynchronous or synchronous communication and technology-based service intended to be used to decide whether an office visit or other service is needed. The encounter may involve synchronous discussion over a phone or exchange of information through video or image. A provider may respond to the member’s concern by phone, audio-visual communications, or a secure patient portal. Covered services include both the remote evaluation of a recorded video or image submitted by a member and the interpretation and follow-up by the provider.
An e-visit is a communication between a member and their provider through an online HIPAA-compliant patient portal. These patient-initiated asynchronous services involve a member having non-face-to-face communications cumulatively over a span of seven days with a provider with whom they have an established relationship. Providers who can bill E&M services may utilize online digital E&M codes while other providers may be eligible to bill online assessment and management codes.
Allowable procedure codes for virtual check-in and e-visit services can be found in the Manual section.
These services do not require prior authorization and are patient-initiated by established patients of the provider’s practice.
Virtual check-in and e-visit telehealth services are not covered or billable if they:
- Take place during an in-person visit.
- Take place within seven days after an in-person visit furnished by the same provider.
- Trigger an in-person visit within 24 hours or the soonest available appointment.
- Do not have sufficient information from the remote evaluation of an image or video (store and forward) for the provider to complete the service.
Only the relevant in-person procedure code that was rendered would be reimbursed if any of the above conditions apply.
Telephone Evaluation and Management Services: See handbook for list of reimbursable for telephone E&M service codes.
SOURCE: Virtual Check-In, E-Visit and Telephone Evaluation and Management Services, Topic #22742. (Accessed Apr. 2025).
Can I receive services by phone (audio-only)?
Some services can be delivered over the phone with the same quality and effectiveness as an in-person service. These services can be provided by phone (audio-only). Your provider will let you know which type of technology is right for your appointment.
Modifiers
Providers should include all applicable modifiers to identify the delivery method for telehealth services. Claims for synchronous telehealth services should be indicated by one or more
of the following applicable modifiers:
- 93 (Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system)
- FQ (A telehealth service was furnished using audio-only communication technology) Use this modifier when the patient is unable to use audio and video communications. (This modifier is for behavioral health services
only.)
Note: The FQ and FR modifiers are for behavioral health services only.
Providers are required to include any additional provider, benefit, or service specific modifiers that may apply to a service code when delivered through telehealth. For example, when a service is provided by a physical therapist (PT), the codes would need to include the corresponding therapy modifier GP (Services delivered under an outpatient physical therapy plan of care) to signify the telehealth service is furnished as therapy services furnished under a PT plan of care.
Claims for services delivered via telehealth must include all modifiers required by the existing benefit coverage policy in order to reimburse the claim correctly. Telehealth delivery of the service is shown on the claim by indicating POS code 02 or 10 and including either the GQ, GT, FQ, or 93 modifier in addition to any other required benefit-specific modifiers.
County-administered programs, school-based services, and any other programs that utilize cost reporting must include required modifiers, such as renderer credentials and group versus individual services, as well as correct details for cost reporting to ensure correct reimbursement.
Note: The GT, FQ or 93 modifiers may not be listed on the fee schedule, but it is still required on all claim submissions that use POS code 02 or 10 to indicate the telehealth service was performed synchronously. The GQ modifier is required to indicate the telehealth service was performed asynchronously.
Audio Only Guidelines
When possible, telehealth services should include both an audio and visual component. In circumstances where audio-visual telehealth is not possible due to member preference or technology limitations, telehealth may include real-time interactive audio-only communication if the provider feels the service is functionally equivalent to the in-person service and there are no face-to-face or in-person restrictions listed in the procedural definition of the service.
Documentation should include that the service was provided via interactive synchronous audio-only telehealth.
Modifier 93 should be used for any service performed via audio-only telehealth. The GT modifier should only be used to indicate services that were performed using audio-visual technology.
SOURCE: ForwardHealth Telehealth Policy Topic #510, (Accessed Apr. 2025).
The Department may promulgate rules specifying any telehealth service that is provided solely by audio-only telephone, facsimile machine or electronic mail as reimbursable under Medical Assistance.
SOURCE: WI Statute Sec. 49.45 (61). (Accessed Apr. 2025).
Behavioral Health Services
Behavioral health services should be indicated by the following modifiers.
- FQ*: A telehealth service was furnished using audio-only communication technology
- FR*: A supervising practitioner was present through a real-time two-way, audio/video communication technology
- GQ: Via asynchronous telecommunications system
- GT: Via interactive audio and video telecommunication systems
*Use for behavioral health services only.
Interprofessional Consultations (E-Consults)
An interprofessional consultation or e-consult is an assessment and management service in which a member’s treating provider requests the opinion and/or treatment advice of a provider with specific expertise (the consultant) to assist the treating provider in the diagnosis and/or management of the member’s condition without requiring the member to have face-to-face contact with the consultant. Both the treating and consulting providers may be reimbursed for the e-consult as described below.
Consulting providers must be physicians enrolled in Wisconsin Medicaid as an eligible rendering provider. Consulting providers may bill CPT procedure codes 99446–99449 and 99451 under the following limitations:
- Services are not covered if the consultation leads to a transfer of care or other face-to-face service within the next 14 days or next available date of the consultant. Additionally, if the sole purpose of the consultation is to arrange a transfer of care or other face-to-face service, these procedure codes should not be submitted.
- Consulting services are covered once in a seven-day period.
Treating providers may be a physician, nurse practitioner, physician assistant, or podiatrist enrolled in Wisconsin Medicaid as an eligible rendering provider. Treating providers may bill CPT procedure code 99452 as a covered service once in a 14-day period.
Both the consulting and treating providers must be enrolled in Wisconsin Medicaid to receive reimbursement for the e-consult and the consultation must be medically necessary.
Providers are expected to follow CPT guidelines including that the CPT procedure codes should not be submitted if the consulting provider saw the member in a face-to-face encounter within the previous 14 days.
Crisis Intervention, Birth to 3 Telehealth Services, and Community Health Centers may use the FQ (audio-only) modifier.
SOURCE: WI ForwardHealth Online Handbook, Topic #6777, Topic #22617, & Topic #21997. (Accessed Apr. 2025).
- The consultation is a professional service furnished to a recipient by a certified provider at the request of the treating provider.
- The consultation constitutes an evaluation and management service in which the certified provider treating a recipient requests the opinion or treatment advice of a consulting provider with specific expertise to assist the treating provider in the evaluation or management of the recipient’s problem without requiring the recipient to have face–to–face contact with the consulting provider.
- The consulting provider provides a written report that becomes a part of the recipient’s permanent medical record.
SOURCE: Department of Health Services Administrative Rules Sec. 107.06(4)(cm), (Accessed Apr. 2025).
Except as provided in par. (b), outpatient psychotherapy services shall be covered services when provided by a provider certified under s. DHS 105.22, and when the following conditions are met: … Psychotherapy is performed only in any of the following: …
- Via telehealth when the provider is in a location that ensures privacy and confidentiality of recipient information and communications.
The provider who performs psychotherapy shall engage in contact with the recipient in person, via real-time interactive audio-visual telehealth, or real-time interactive audio-only telehealth for at least 5/6 of the time for which reimbursement is claimed under MA.
AODA treatment services are performed only in the office of the provider, a hospital or hospital outpatient clinic, an outpatient facility, a nursing home or a school or by telehealth when functionally equivalent to services provided in person.
The provider who performs AODA treatment services shall engage in contact with the recipient in person, via real-time interactive audio-visual telehealth, or real-time interactive audio-only telehealth for at least 5/6 of the time for which reimbursement is claimed.
Supervision – Ancillary Care Providers
For telehealth services, the supervising physician is not required to be onsite, but they must be able to interact with the member using real-time audio or audiovisual communication, if needed. For supervision of ancillary providers, remote supervision is allowed in circumstances where the physician feels the member is not at risk of an adverse event that would require hands-on intervention from the physician.
SOURCE: WI ForwardHealth Online Handbook. Topic #22757, Supervision, (Accessed Apr. 2025).
Interpretive Services
Claims for interpretive services must include HCPCS procedure code T1013 and the appropriate modifier(s):
- U1 (Spoken language)
- U3 (Sign Language)
- GT (Via interactive audio and video telecommunication systems)
- 93 (Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system)
SOURCE: WI ForwardHealth Online Handbook. Topic #22917, Interpretive Services, (Accessed Apr. 2025).
Intensive Outpatient Program (IOP) – Behavioral Health
Providers should use informational behavioral health modifiers when they render telehealth services:
- FQ: A telehealth service was furnished using audio-only communication technology
- FR: A supervising practitioner was present through a real time two way audio/video communication technology
- GQ: Via asynchronous telecommunications system
- GT: Via interactive audio and video telecommunication system
Medically Tailored Meals
Medically tailored meals are fresh or frozen prepared meals customized by a registered dietitian (RD) to meet a member’s unique health needs.
Meals must be provided under the supervision of an RD who is licensed to practice in Wisconsin. This means:
- The dietitian must meet the member to develop a meal plan tailored to the member’s specific needs. This visit may occur either in person or via real time, interactive, audio-visual or audio-only telehealth. Nutritional counseling code S9470 can be delivered via real-time interactive, audio-only telehealth visits.