Telehealth lets healthcare providers deliver care remotely through secure video calls, phone consultations, or digital platforms, expanding access for patients who can’t visit in person—think follow-ups, mental health sessions, or chronic disease management from anywhere.

Telehealth billing is the process of submitting insurance claims for these virtual services, using specific CPT codes, modifiers, and payer rules to secure reimbursements just like in-office visits. 

It surged during COVID-19 as a lifeline for care continuity, and many insurers like Medicare and major commercial have kept flexible policies in place to support ongoing virtual delivery.

Billing rules hinge on accurate coding and documentation, varying by payer—mastering them ensures steady revenue. In this article, we’ll cover codes, modifiers, pitfalls, and more to keep your claims flowing smoothly.

Types of Telehealth Services Providers Can Bill

Telehealth services fall into several billable categories, each with specific CPT codes and payer guidelines—knowing these helps you maximize reimbursements for virtual care.

Here’s a quick overview:

Not every payer covers all types—Medicare supports video and audio for many E/M services, while commercials might limit audio-only. 

Common Telehealth CPT Codes Providers Should Know

Telehealth billing relies on specific CPT codes tailored to virtual visits—selecting the right one based on service type, time spent, and complexity ensures payers process claims without pushback.

Here are the most frequently used codes:

Always match the code to the visit’s details—e.g., 15 minutes might qualify for 99442—and confirm payer acceptance, as Medicare favors 992xx series with modifiers. 

Telehealth Billing Modifiers (95, GT, 93)

Modifiers are essential “flags” on telehealth claims that tell payers the service happened virtually—they’re required to avoid automatic denials, but rules vary by insurer, so double-check each one’s guidelines.

Here’s a breakdown of the most common ones:

Append these to CPT codes like 99213-95 for a 15-minute video follow-up; Medicare often wants GT, while commercials lean toward 95. Mixing them up or skipping them triggers rejections. 

Place of Service (POS) Codes for Telehealth Claims

Place of Service (POS) codes tell payers where the telehealth service was “delivered” from the patient’s perspective, even though it’s virtual—using the wrong one leads to claim rejections or underpayments, as it affects reimbursement rates.

Here are the key POS codes for telehealth:

Medicare and many commercials default to POS 10 for home-based sessions, reflecting that higher facility costs aren’t involved, while POS 02 applies if the patient is at work or another non-home site. Always document locations clearly in notes to back your choice. 

Documentation Requirements for Telehealth Billing

Solid documentation is the backbone of successful telehealth billing—payers scrutinize notes during audits to confirm the service met medical necessity, compliance standards, and billing rules, so skimping here invites denials or repayments.

Key elements to include in every telehealth encounter:

• Patient consent: Document verbal or written agreement to virtual care, risks, and privacy measures (e.g., “Patient consented to video visit via secure platform”).
• Technology used: Note the platform (e.g., Zoom for Healthcare, Doxy.me) and confirm it was secure, HIPAA-compliant.
• Provider and patient locations: Specify both (e.g., “Provider in office, patient at home”) to justify the POS code.
• Visit duration and content: Record time spent, exam findings (visual/audio), history, assessment, and plan—just like in-person E/M.
• Clinical rationale: Explain why telehealth was appropriate (e.g., follow-up stable hypertension, no physical exam needed).

These details protect against audits and support code selection (e.g., 99214 for moderate complexity).

Common Telehealth Billing Mistakes Providers Should Avoid

Telehealth billing trips up even seasoned practices with simple oversights that lead to denials, rework, and lost revenue—avoiding them keeps your claims clean and cash flowing.

Watch out for these frequent errors:

• Missing telehealth modifiers like -95, -GT, or -93, causing payers to flag claims as in-office instead of virtual.
• Incorrect CPT codes, such as using standard 99213 without a time/service match for audio-only (stick to 99441-99443).
• Wrong POS codes—billing POS 11 (office) for a home video visit triggers rejections or rate cuts.
• Insufficient documentation, like skipping consent or location details, failing audits, and inviting repayments.
• Billing non-covered services, ignoring payer policies (e.g., some commercials exclude audio-only post-COVID).

Tips to sidestep these: Run payer policy checks before visits, train staff on code-modifier combos, and audit a sample of claims weekly. 

How Medical Billing Services Can Help Providers Manage Telehealth Billing

Professional medical billing services take the complexity out of telehealth claims, ensuring accuracy and compliance so you get paid faster without the daily headaches.

We expertly select the right CPT codes (like 99214 for video E/M or G2012 for check-ins), apply precise modifiers (-95, GT, or 93) and POS codes (02 or 10), and verify payer-specific telehealth policies upfront to match every detail to coverage rules. 

Our team handles documentation reviews, catching gaps like missing consent or location notes before submission, while preventing denials through proactive payer portal checks and appeals.

At MedAce, we optimize your entire telehealth revenue cycle—boosting clean claim rates above 95%, cutting AR days, and recovering 70%+ of denials for steady cash flow. This lets you focus on growing your virtual practice and patient care, not coding puzzles.

Ready to simplify telehealth billing? Contact us &—we’ll get your claims reimbursed right the first time.

FAQ

1. What exactly is telehealth billing?

Telehealth billing is the way you get paid for providing healthcare remotely. Instead of a patient coming to your office, you see them through a video call or speak to them on the phone. You still submit a claim to the insurance company just like an in-person visit, but you have to use specific codes and “flags” to show that the care was virtual.

2. Which codes should I use for a standard video visit?

For most video visits where you are evaluating a patient, you will use the same codes you use in the office, which are 99202 through 99215. The big difference is that you must add a special two-digit code called a modifier to let the insurance company know the visit happened over a secure video link rather than face-to-face.

3. What is a modifier, and why is it required?

A modifier is an extra tag you add to a billing code to provide more details. In telehealth, common modifiers like 95 or GT tell the insurer that the service was “synchronous,” meaning you and the patient were talking in real-time. If you forget this tag, the insurance company might deny the claim because it looks like an office visit with missing location data.

4. Does the patient’s location matter for the claim?

Yes, you have to tell the insurance company where the patient was during the call using a Place of Service code. You will typically use code 10 if the patient was in their own home, which is the most common scenario. If the patient was at a workplace or another clinic, you would use code 02 instead.

5. What needs to be in my notes to get the claim approved?

Your clinical notes need to prove the visit met all safety and privacy rules. You must write down that the patient consented to a virtual visit, name the specific secure platform you used for the call, and list the physical locations of both the doctor and the patient. Without these details, you could lose your payment if you are ever audited.

6. Can I bill for a simple phone call without video?

You can often bill for audio-only calls using codes 99441 through 99443, but you have to be careful. While Medicare and many large insurers still pay for phone consultations, some smaller private insurance companies stopped covering them after the pandemic ended. It is always a good idea to check the specific payer’s rules before the call starts.