Telehealth Billing Cheat Sheet (2026)
Telehealth billing fails on two small fields more than anything else: the place of service and the modifier, which have to agree with each other and with the payer's current policy. Add e-visit time tiers and remote monitoring device rules and the detail compounds.
Quick reference for telehealth billers. Last updated .
Top Telehealth CPT Codes & 2026 Medicare Allowables
| Code | Description | Non-Facility | Facility | Total RVU |
|---|---|---|---|---|
| 99421 | Online digital E/M service, 5-10 minutes | $15.70 | $11.02 | 0.47 |
| 99422 | Online digital E/M service, 11-20 minutes | $30.73 | $22.38 | 0.92 |
| 99423 | Online digital E/M service, 21+ minutes | $48.77 | $35.07 | 1.46 |
| 98966 | Telephone E/M service, 5-10 minutes | $13.69 | $10.35 | 0.41 |
| 98967 | Telephone E/M service, 11-20 minutes | $25.05 | $20.04 | 0.75 |
| 98968 | Telephone E/M service, 21-30 minutes | $34.74 | $29.06 | 1.04 |
| 99457 | Remote patient monitoring, first 20 minutes | $51.77 | $26.39 | 1.55 |
| 99458 | Remote patient monitoring, each additional 20 minutes | $41.42 | $26.39 | 1.24 |
| 99213 | Established office visit (bill with modifier 95 for video telehealth) | $95.19 | $57.45 | 2.85 |
| 99214 | Established office visit (bill with modifier 95 for video telehealth) | $135.61 | $84.50 | 4.06 |
National 2026 Medicare Physician Fee Schedule estimates (total RVU multiplied by the conversion factor). These are adjusted by state locality. See the per-state table on the Telehealth billing services page.
Modifiers That Prevent Telehealth Denials
A synchronous service delivered by real-time audio and video.
A synchronous service delivered audio-only, where the payer permits it.
An audio-only behavioral health service where the payer or program requires the FQ designator.
The supervising practitioner was present by real-time audio and video where that is required and recognized.
Telehealth via interactive audio and video for the payers and institutional claims that still require GT instead of 95.
Place of service 10 when the patient is at home, 02 when the patient is in another location; it must match the modifier and payer policy.
Top Telehealth Denials → Quick Fix
POS 10 (patient home) or 02 (other) has to align with modifier 95 or 93 and the payer's current telehealth policy. A mismatch auto-denies.
Use modifier 93 (or FQ for behavioral health where required) for audio-only. Billing it as audio-video when no video occurred is a coding-accuracy denial.
99421 to 99423 are cumulative time over seven days for a patient-initiated digital inquiry. Document the cumulative time and that the patient initiated it.
99457 requires the monitoring time and an interactive communication; the device data days requirement must also be met for the setup code. Document each element.
Confirm the specific code is telehealth-eligible for that payer in 2026 before delivering it virtually; post-PHE lists are narrower and vary by payer.
NCCI Bundling Watch-Outs
Code pairs from this specialty's set that carry NCCI edits. Billing both without a justified modifier triggers a bundling denial.
| Code | Bundles With | Rationale |
|---|---|---|
| 99421 | 0362T | Misuse of Column Two code with Column One code |
| 99421 | 0373T | Misuse of Column Two code with Column One code |
| 99422 | 0362T | Misuse of Column Two code with Column One code |
| 99422 | 0373T | Misuse of Column Two code with Column One code |
| 99423 | 0362T | Misuse of Column Two code with Column One code |
| 99423 | 0373T | Misuse of Column Two code with Column One code |
| 98966 | 36591 | CPT Manual or CMS manual coding instruction |
| 98966 | 36592 | CPT Manual or CMS manual coding instruction |
Documentation That Holds Up on Appeal
Modality (audio-video or audio-only), patient location, and consent, supporting the modifier and place of service.
That the patient initiated the digital inquiry and the cumulative time across the seven-day period.
The call time and that it did not lead to an E/M within the bundling window.
The monitoring time, the interactive communication, and the device data-day threshold for setup.
That the code is telehealth-eligible for the specific payer under current policy.
Revenue Telehealth Practices Leave on the Table
Auto-denials from a place of service that does not match the modifier or current payer policy.
Billing audio-only encounters as audio-video, which fails on audit.
Not billing e-visits and RPM because the time and device criteria were not documented, leaving real work uncaptured.
Delivering a non-eligible code virtually and losing the visit entirely.
Telehealth Billing FAQ
POS 10 or 02 for telehealth?
POS 10 when the patient is at home, POS 02 when the patient is at another site. Whichever applies has to agree with the modifier (95 or 93) and the payer's current policy, or the claim auto-denies.
When do I use modifier 93?
For synchronous audio-only services where the payer allows them. Behavioral health audio-only may also require FQ. Billing audio-only as audio-video is a coding-accuracy denial.
How are e-visits billed?
99421 to 99423 are patient-initiated digital inquiries billed on cumulative time over a seven-day period. Both the patient initiation and the cumulative time have to be documented.
What changed after the public health emergency?
Telehealth-eligible code lists narrowed and vary by payer. Confirm the specific code is telehealth-eligible for that payer in 2026 before delivering it virtually.
Stop Losing Telehealth Revenue to Preventable Denials
Our AAPC-certified telehealth coders apply every rule on this sheet to your claims. Call 888-701-6090 for a free billing assessment.