As telehealth continues to transform how patients access care, the ability for healthcare providers to optimize reimbursement through accurate billing and coding practices is more important than ever. In 2025, telehealth billing has evolved with fresh regulations, Medicare updates, and new strategies for managing telehealth claims efficiently.
To help you stay ahead of the curve, we asked leading experts in the field to share their advice on navigating reimbursement, improving billing processes, and understanding the reimbursement landscape—all while staying compliant with payer-specific requirements.
🧠 Expert Opinions on Successful Telehealth Billing in 2025
💬 Dr. Maya Brennan, Primary Care Physician
“The key to successful telehealth billing lies in clarity of documentation and knowing your payers. Even with remote patient monitoring (RPM services), if you don’t meet the documentation requirements, you risk not being eligible for reimbursement.”
🔑 Pro Tip: Use telehealth-specific billing codes and make sure each telehealth encounter includes time-based and location-based notes, especially for Medicaid services and virtual check-ins.
💬 Sarah Lind, Telehealth Program Director
“Investing in advanced billing platforms and training your billing staff to handle payer requirements has become critical. A lot of billing solutions now offer features specific to telehealth visits, which help streamline the entire billing process.”
🔑 Pro Tip: Use POS 10 for in-person care delivered via telehealth at home and ensure modifier 93 is used for audio-only services.
💬 James Okafor, Reimbursement Strategist
“Many telehealth services are now being integrated into patient-centered care models. But the nuances of telehealth billing—especially coding requirements for Medicare vs. Medicaid—can lead to denied claims if you’re not careful.”
🔑 Pro Tip: Review telehealth reimbursement policies weekly; CMS updates coverage and reimbursement policies often, and they don’t always align with commercial payer expectations.
📊 Quick Stats for Billing Pros (April 2025)
82% of practices reported billing errors due to using outdated telehealth billing codes.
Modifier 93 adoption rose by 40% in Q1 2025 for audio-only virtual service claims.
30% of Medicaid providers are still using incorrect POS codes, risking reimbursement delays.
✅ Billing Best Practices for 2025
Stay current with reimbursement guide updates from CMS and state agencies.
Automate efficient telehealth billing workflows.
Train staff on the latest telehealth technology and telehealth platforms.
Ensure coding and documentation aligns with virtual care and in-person services delivered remotely.
Follow proven billing strategies tailored to reimbursement for telehealth services.
🔍 Real-World Story
🦨 A rural primary care clinic in Nebraska increased telehealth reimbursement by 22% after implementing AI-driven billing solutions and aligning workflows with 2025 telehealth regulations.
📚 References – April 2025 Updates
CMS 2025 Telehealth Fact Sheet – Covers Medicare and Medicaid policies for telehealth reimbursement and telehealth billing practices.
📍 Read the CMS factsheetCoronis Health: New Telehealth Billing Codes in 2025 – Practical tips for billing staff using appropriate billing codes for reimbursement processes.
📍 Visit Coronis Health’s blogRapidClaims AI: Telehealth Billing Tips for 2025 – Insights into telehealth technology and maximizing claims with smart billing strategies.
📍 Read RapidClaims’ insights
❓ Frequently Asked Questions (FAQ) on Telehealth Billing & Reimbursement
Q1: What are the key changes in telehealth billing for 2025?
A: Medicare continues using standard E/M codes. Use modifier 93 for audio-only visits. Apply POS 10 for at-home care and POS 02 for other remote settings.
Q2: How can I ensure maximum reimbursement for telehealth services?
A: Use appropriate billing codes, ensure complete coding and documentation, check payer-specific requirements, and follow updated telehealth reimbursement policies.
Q3: Are virtual check-ins and RPM services eligible for reimbursement?
A: Yes, when billed correctly and meeting documentation requirements. These are considered eligible telehealth services under most coverage and reimbursement policies.
Q4: How do I bill for in-person equivalent services delivered via telehealth?
A: Use standard E/M codes, append relevant modifiers, and indicate telehealth with the correct POS code.
Q5: What tools help streamline telehealth billing?
A: Adopt advanced billing platforms that support telehealth billing features, automation, and compliance with payer requirements.
📌 Hashtags for Sharing:
#TelehealthBilling #VirtualCare #MaximizeReimbursement #2025Healthcare #BillingStrategies #RemotePatientMonitoring #MedicareBilling #TelehealthCoverage #OptimizeBilling #PatientCenteredCare
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