MedicaidBilling CodesMedium impact
DHCS Telehealth Modifier Requirements
L.A. Care Health Plan·CA·Coding
Effective date
Sep 30, 2024
We identified it
Jun 20, 2026
Summary
DHCS now requires FQHC, RHC, IHS-MOA, and Tribal FQHC providers to include specific telehealth modifiers (93, 95, or GQ) on the informational line of telehealth claims. L.A. Care will remediate previously denied claims back to January 1, 2023.
Action Required
Immediately: FQHC, RHC, IHS-MOA, and Tribal FQHC billing teams must add modifier 93 (audio-only telehealth), 95 (audio-video telehealth), or GQ (asynchronous telehealth) to the informational line of all telehealth claims submitted to L.A. Care Health Plan. Update billing system templates to require appropriate telehealth modifier selection. Contact L.A. Care Provider Account Manager for questions about remediation reports for previously denied claims.