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Telehealth Billing Services

Telehealth billing adds layers of complexity with place-of-service distinctions, modifier requirements, audio-only rules, state parity laws, and remote patient monitoring codes that most billing teams handle incorrectly.

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All 50 States
Starting at 2.49%
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HIPAA Compliant
AAPC Certified
4.9/5 Rating
300+ Practices
POS 02Telehealth Facility
Mod 95Synchronous
99458RPM
99441Phone E/M

Why Telehealth Billing Requires Specialty Expertise

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.

Common Telehealth CPT Codes

Our coders handle these telehealth codes daily. This is not an exhaustive list.

Code
Description
POS 02
Telehealth Facility
Mod 95
Synchronous
99458
RPM
99441
Phone E/M

Telehealth Billing Challenges We Solve

Common billing problems in telehealth and how our team handles them.

POS 02 vs POS 10 Reimbursement

POS 02 reimburses at facility rates while POS 10 reimburses at non-facility rates — choosing incorrectly reduces reimbursement by 15-30%.

Modifier 95 vs 93 Requirements

Synchronous audio/video visits use modifier 95, audio-only visits use modifier 93, and payers vary on which they accept.

State Parity Law Compliance

40+ states have telehealth parity laws, but each defines parity differently — some cover payment parity, others only coverage parity.

Cross-State Licensing

Providers treating patients across state lines must hold licenses in the patient's state, and billing addresses must reflect the correct location.

Common Telehealth Denial Reasons

We prevent these before submission and appeal aggressively when they occur.

!
POS 02 reimburses at facility rates while POS 10 reimburses at non-facility rates — choosing incorrectly reduces reimbursement by 15-30%
!
Synchronous audio/video visits use modifier 95, audio-only visits use modifier 93, and payers vary on which they accept
!
40+ states have telehealth parity laws, but each defines parity differently — some cover payment parity, others only coverage parity
!
Providers treating patients across state lines must hold licenses in the patient's state, and billing addresses must reflect the correct location

Revenue Opportunities Most Telehealth Practices Miss

Remote patient monitoring represents the single largest untapped telehealth revenue stream. For a practice with 200 eligible chronic-care patients, RPM codes 99453-99458 generate $120-160 per patient per month in recurring revenue — that is $288,000 to $384,000 annually from RPM alone. Setup requires a connected device and 16 days of data transmission per month, but once operational, RPM revenue is almost entirely passive. Telephone E/M codes 99441-99443 represent another missed opportunity. Practices that conduct phone-based follow-ups without billing them are leaving $30-75 per call on the table. For a mid-size practice averaging 15 unbilled phone consultations per day, that is $100,000 to $250,000 in annual revenue from services already being provided.

Payer-Specific Telehealth Billing Tips

Medicare covers telehealth services at the same rate as in-person visits when billed with POS 10 and modifier 95. Audio-only coverage is limited to specific codes and requires modifier 93. Medicare reimburses RPM codes under the Physician Fee Schedule with no geographic restrictions post-pandemic permanent expansions. UnitedHealthcare covers telehealth at parity in most states and accepts modifier 95 on all eligible E/M codes. Anthem BCBS requires modifier 95 and restricts audio-only coverage to behavioral health and certain chronic-care follow-ups. Aetna covers telehealth broadly but requires the rendering provider to be in-network in the patient's state. Cigna reimburses telehealth at in-person rates but caps RPM coverage at 99457 (first 20 minutes only, excluding 99458 add-on). We maintain a payer-specific telehealth policy matrix updated quarterly.

Telehealth Billing Best Practices

Practical tips from our coding team to maximize reimbursement and minimize denials.

1
Use POS 10 (patient at home) for most telehealth visits — it reimburses at the higher non-facility rate. POS 02 (telehealth at originating site) applies only when the patient is at a healthcare facility and reimburses at the lower facility rate.
2
Modifier 95 is required on all synchronous audio/video E/M claims. Omitting it causes denials with Medicare and most commercial payers. For audio-only visits, use modifier 93 where the payer accepts it.
3
RPM codes are billable monthly: 99453 (initial device setup, one-time), 99454 (device supply/data transmission, monthly), 99457 (first 20 min clinical monitoring), and 99458 (each additional 20 min). A single RPM patient generates $120-160/month in recurring revenue.
4
Telephone E/M codes 99441 (5-10 min), 99442 (11-20 min), and 99443 (21-30 min) are separately billable when the call doesn't result in an in-person visit within 24 hours. Many practices miss these entirely.
5
Document the patient's physical location (state and setting) for every telehealth encounter — payers audit this to verify the provider is licensed in that state and the POS code is correct.

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What We Handle for Telehealth Practices

POS code and modifier assignment for all telehealth visits
Audio-only billing with modifier 93 compliance
Remote patient monitoring coding (99453-99458)
Telephone E/M coding (99441-99443)
State parity law tracking and enforcement
Cross-state licensing verification
Telehealth credentialing with payers
Asynchronous (store-and-forward) billing

Why Choose Go Medical Billing for Telehealth

Telehealth billing errors cost practices thousands monthly through incorrect POS codes, missed modifiers, and failure to bill RPM and phone E/M codes. Our team tracks payer-specific telehealth policies across all 50 states.

We serve telehealth practices in all 50 states, starting at 2.49% of collections. Our credentialing team handles payer enrollment, and our A/R specialists recover aging claims.

Telehealth Billing by State

We handle telehealth billing in all 50 states. Select your state for location-specific payer details, Medicaid rules, and Medicare MAC policies.

CaliforniaTexasFloridaNew YorkPennsylvaniaIllinoisOhioGeorgiaNorth CarolinaMichiganNew JerseyVirginiaMassachusettsArizonaTennesseeMarylandIndianaMissouriWisconsinColorado
View all 50 states

Related Resources

Medical Billing & Coding ServicesA/R Recovery ServicesCredentialing & ContractingCase Studies & ResultsPricing

Frequently Asked Questions

Yes. We handle the full RPM code set (99453-99458) including initial setup, monthly device management, and clinical staff time. We also verify each payer's RPM coverage policies before enrollment.
We maintain a telehealth parity and licensing matrix for all 50 states, tracking which services are covered, audio-only rules, and cross-state licensing requirements. This ensures every claim complies with the patient's state regulations.

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Stop losing revenue to telehealth coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.

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