Telehealth Billing Services in Maryland
Maryland's telehealth practices face unique billing challenges shaped by CareFirst BlueCross BlueShield's commercial rules, HealthChoice requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both MD payer rules and telehealth coding complexity.
Why Maryland Telehealth Practices Need Specialized Billing
Maryland's healthcare market includes 22,000+ physicians, and telehealth practices here face a payer market dominated by CareFirst BlueCross BlueShield on the commercial side and HealthChoice on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect telehealth procedure coverage and medical necessity requirements. Generic billing teams without MD 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 Maryland's specific payer rules, authorization requirements, and 5 HealthChoice 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 Baltimore to Bethesda and across Maryland.
Top CPT Codes for Telehealth in Maryland
Our MD coders handle these telehealth codes daily, applying Novitas Solutions Medicare rules and CareFirst BlueCross BlueShield commercial policies to each claim.
Maryland Payer Challenges for Telehealth
Every MD payer has specific rules for telehealth claims. Here's how we navigate them.
CareFirst BlueCross BlueShield Telehealth Claims
CareFirst BlueCross BlueShield processes the largest share of Maryland commercial telehealth claims. We know their MD 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%.
HealthChoice Telehealth Billing
HealthChoice routes telehealth patients through 5 managed care plans: CareFirst Community, Aetna Better Health, Molina, and 2 more. Each MCO has its own telehealth authorization and billing rules that we manage.
Medicare (Novitas Solutions) Telehealth Coverage
Novitas Solutions processes Medicare telehealth claims in Maryland with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around modifier 95 vs 93 requirements to prevent medical necessity denials.
Denial Prevention for Maryland Telehealth
Common telehealth denials in Maryland 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 MD payer-specific documentation when denials occur.
Get Expert Telehealth Billing in Maryland
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What We Handle for Maryland Telehealth Practices
Maryland Telehealth Billing Cost Comparison
Hiring an in-house biller with telehealth expertise in Maryland costs $42K-$55K 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 MD payer specialists for a fraction of that cost.
$42K-$55K
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 Maryland and telehealth billing resources.
Frequently Asked Questions
Fix Your Maryland Telehealth Billing
Call 888-701-6090 for a free billing assessment specific to your MD telehealth practice. We'll show you where revenue is leaking and how to fix it.