Telehealth Billing Services in California
California's telehealth practices face unique billing challenges shaped by Blue Shield of California / Anthem's commercial rules, Medi-Cal requirements, and Noridian Medicare policies. Our AAPC-certified coders specialize in both CA payer rules and telehealth coding complexity.
Why California Telehealth Practices Need Specialized Billing
California's healthcare market includes 110,000+ physicians, and telehealth practices here face a payer market dominated by Blue Shield of California / Anthem on the commercial side and Medi-Cal on the public payer side. Medicare claims are processed through Noridian, which applies its own Local Coverage Determinations that directly affect telehealth procedure coverage and medical necessity requirements. Generic billing teams without CA specific knowledge leave revenue on the table.
Telehealth billing itself is complex. Telehealth billing requires precise modifier and place-of-service coding that varies by payer and state. The distinction between POS 02 (telehealth facility) and POS 10 (telehealth patient home) affects reimbursement rates. Modifier 95 designates real-time audio/video services, while modifier 93 covers audio-only visits. Remote patient monitoring codes 99453-99458 and telephone E/M codes 99441-99443 add further billing opportunities that many practices miss entirely. When you combine this coding complexity with California's specific payer rules, authorization requirements, and 5 Medi-Cal managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving telehealth practices from Los Angeles to Oakland and across California.
Top CPT Codes for Telehealth in California
Our CA coders handle these telehealth codes daily, applying Noridian Medicare rules and Blue Shield of California / Anthem commercial policies to each claim.
California Payer Challenges for Telehealth
Every CA payer has specific rules for telehealth claims. Here's how we navigate them.
Blue Shield of California / Anthem Telehealth Claims
Blue Shield of California / Anthem processes the largest share of California commercial telehealth claims. We know their CA specific fee schedules, prior authorization requirements for telehealth procedures, and their appeal timelines when claims are denied. POS 02 reimburses at facility rates while POS 10 reimburses at non-facility rates — choosing incorrectly reduces reimbursement by 15-30%.
Medi-Cal Telehealth Billing
Medi-Cal routes telehealth patients through 5 managed care plans: LA Care, Health Net, Molina, and 2 more. Each MCO has its own telehealth authorization and billing rules that we manage.
Medicare (Noridian) Telehealth Coverage
Noridian processes Medicare telehealth claims in California with its own Local Coverage Determinations. We navigate Noridian's policies around modifier 95 vs 93 requirements to prevent medical necessity denials.
Denial Prevention for California Telehealth
Common telehealth denials in California include pos 02 reimburses at facility rates while pos 10 reimburses at non-facility rates — choosing incorrectly reduces reimbursement by 15-30% and synchronous audio/video visits use modifier 95, audio-only visits use modifier 93, and payers vary on which they accept. Our team catches these issues before submission and appeals aggressively with CA payer-specific documentation when denials occur.
Get Expert Telehealth Billing in California
Free billing assessment for your CA telehealth practice. See where revenue is leaking.
What We Handle for California Telehealth Practices
California Telehealth Billing Cost Comparison
Hiring an in-house biller with telehealth expertise in California costs $50K-$70K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified telehealth coders and CA payer specialists for a fraction of that cost.
$50K-$70K
In-House Biller Salary
+ benefits, software, space
2.49%
Go Medical Billing Rate
Full team, all services included
60-80%
Typical Cost Reduction
With better results
Related Pages
Explore our California and telehealth billing resources.
Frequently Asked Questions
Fix Your California Telehealth Billing
Call 888-701-6090 for a free billing assessment specific to your CA telehealth practice. We'll show you where revenue is leaking and how to fix it.