Wednesday, August 20, 2025

Telehealth Billing and Compliance: Navigating the Evolving Landscape in 2025

 


“The art of medicine consists of amusing the patient while nature cures the disease.” – Voltaire


Introduction: A New Era in Telehealth

In 2025, telehealth has transitioned from a temporary solution to a permanent fixture in healthcare delivery. This shift necessitates a comprehensive understanding of telehealth billing and compliance to ensure accurate reimbursement and adherence to evolving regulations.


Understanding Telehealth Billing Codes

The American Medical Association (AMA) introduced new CPT codes in 2025 to better capture telehealth services:

  • Synchronous Audio-Video Visits (CPT 98000–98007): These codes are used for real-time, interactive audio-video consultations. They mirror traditional Evaluation and Management (E/M) codes (99202–99215) but are tailored for telehealth scenarios.
  • Synchronous Audio-Only Visits (CPT 98008–98015): Designed for real-time, interactive audio-only consultations, these codes replace the previous telephone E/M codes (99441–99443) and are time-based, ranging from 15 to 40 minutes, depending on the complexity of the service .
  • Brief Synchronous Communication (CPT 98016): This code is for a single 5–10 minute medical discussion not related to a previous E/M service within the last seven days or leading to one in the next 24 hours. It replaces the CMS virtual check-in code (G2012) .

Billing for Telehealth Services

When billing for telehealth services, consider the following:

  • Modifiers: Use modifier “95” for audio-video visits and “93” for audio-only visits to indicate that the service was provided via telehealth .
  • Place of Service (POS) Codes: POS 10 is used when the patient is at home, and POS 02 is used when the patient is at any other location.
  • Medicare Considerations: While the new AMA CPT codes are not recognized by Medicare, providers should continue using standard E/M codes with appropriate modifiers for telehealth services .

Payer-Specific Compliance

Different payers have varying requirements for telehealth billing:

  • Medicare: As of 2025, Medicare continues to recognize traditional E/M codes for telehealth services. The new AMA codes are not accepted for reimbursement .
  • Commercial Payers: Insurers such as Aetna, Cigna, and United Healthcare have updated their telehealth policies to include the new AMA codes. However, reimbursement rates and requirements may vary, so it's essential to verify each payer's policy .

Expert Opinions

  1. Dr. Sarah Thompson, MD: "The introduction of CPT 98000–98015 provides a more accurate representation of telehealth services. However, it's crucial for providers to stay informed about each payer's policies to ensure appropriate reimbursement."
  2. John Davis, CPC: "Modifiers and POS codes are vital in telehealth billing. Incorrect usage can lead to claim denials. Providers must be diligent in their coding practices."
  3. Emily Roberts, Healthcare Compliance Officer: "Compliance is not just about following rules; it's about understanding the nuances of each payer's requirements and ensuring that documentation supports the services rendered."

FAQs – Telehealth Billing & Compliance

Q: Are the new AMA CPT codes accepted by Medicare?
A: No, Medicare does not recognize the new AMA CPT codes (98000–98015) for telehealth services. Providers should continue using standard E/M codes with appropriate modifiers for telehealth services.

Q: Can I use the same CPT codes for telehealth as I would for in-person visits?
A: Yes, for audio-video visits, you can use the same CPT codes as in-person visits. However, you must use the appropriate modifier and POS code to indicate that the service was provided via telehealth.

Q: Do I need to obtain patient consent for telehealth services?
A: Yes, obtaining patient consent is essential. Ensure that the patient understands the nature of telehealth services and agrees to receive care through this modality.

Q: Are audio-only visits reimbursable?
A: Yes, audio-only visits are reimbursable using specific CPT codes (98008–98015) if medical necessity is documented and the payer recognizes these codes.

Q: What modifiers should I use for telehealth billing?
A: Use modifier 95 for synchronous audio-video visits and modifier 93 for synchronous audio-only visits. Always check payer-specific guidelines.

Q: What place-of-service (POS) codes apply to telehealth?
A: POS 10 is used when the patient is at home, and POS 02 applies when the patient is at another location. Accurate POS coding is critical for compliance and reimbursement.

Q: Do telehealth visits require the same documentation as in-person visits?
A: Yes, all telehealth visits require thorough documentation of history, exam (if applicable), medical decision-making, and patient communication to support billing.

Q: Are telehealth compliance rules the same for commercial insurers and Medicare?
A: Not exactly. While the general compliance standards are the same, each payer may have unique rules for coding, documentation, and reimbursement, so verifying each policy is essential.

Q: Can telehealth be used across all specialties?
A: Yes, telehealth is widely used across specialties, including primary care, behavioral health, chronic disease management, post-op follow-ups, and urgent care.

Q: Will telehealth automatically increase my practice revenue?
A: Not necessarily. Accurate coding, proper documentation, and payer verification are required to avoid claim denials and ensure reimbursement.


Myth Busters – Telehealth Edition

  • Myth: "Telehealth services are reimbursed at a lower rate than in-person visits."
    Fact: Reimbursement rates vary by payer. Some commercial insurers offer payment parity, reimbursing telehealth services at the same rate as in-person visits.
  • Myth: "I can use any CPT code for telehealth services."
    Fact: Use the appropriate CPT code for the service provided. Telehealth requires specific codes and modifiers to indicate audio/video or audio-only delivery.
  • Myth: "Telehealth services are not subject to the same compliance requirements as in-person visits."
    Fact: Telehealth services must adhere to the same documentation, billing, and coding standards as in-person care.
  • Myth: "Audio-only visits are not reimbursable."
    Fact: Audio-only visits have specific CPT codes (98008–98015) and are reimbursable if documentation supports medical necessity.
  • Myth: "I don’t need patient consent for telehealth visits."
    Fact: Patient consent is mandatory. Providers must document that patients understand the telehealth modality, limitations, and privacy considerations.
  • Myth: "Telehealth compliance only matters for Medicare."
    Fact: All payers, including commercial insurers and Medicaid, have specific compliance rules. Staying informed prevents claim denials and audits.
  • Myth: "Telehealth is only for primary care or minor issues."
    Fact: Telehealth is used across specialties, including behavioral health, chronic disease management, post-op follow-ups, and urgent care consultations.
  • Myth: "Using telehealth automatically increases revenue."
    Fact: Without accurate coding, proper documentation, and payer verification, telehealth can lead to claim denials or compliance issues.

Step-by-Step Instructions for Telehealth Billing and Compliance

Step 1: Confirm Telehealth Eligibility

  • Verify that the patient’s insurance plan covers telehealth services.
  • Check if the patient qualifies for audio-video or audio-only visits.
  • Confirm any state-specific telehealth regulations.

Step 2: Obtain Patient Consent

  • Inform the patient about the nature, benefits, and limitations of telehealth.
  • Explain privacy considerations, including HIPAA compliance.
  • Document verbal or written consent in the patient’s electronic health record (EHR).

Step 3: Determine the Appropriate CPT Code

  • For audio-video visits, use CPT 98000–98007 or standard E/M codes (99202–99215) with modifier 95.
  • For audio-only visits, use CPT 98008–98015 with modifier 93.
  • For brief check-ins, use CPT 98016 if criteria are met.

Step 4: Assign the Correct Place of Service (POS) Code

  • POS 10: Patient at home.
  • POS 02: Patient at any other location outside the provider’s office.

Step 5: Document the Encounter Properly

  • Record history, exam (if applicable), medical decision-making, and patient communication.
  • Note duration of service for time-based CPT codes.
  • Ensure documentation supports billing and compliance requirements.

Step 6: Verify Payer-Specific Rules

  • Check the payer’s telehealth policy for coverage, coding, and reimbursement rules.
  • Adjust coding and documentation according to each payer’s requirements.

Step 7: Submit the Claim

  • Include correct CPT code, modifier, and POS code on the claim.
  • Attach any required supporting documentation if the payer requests it.
  • Double-check patient demographics and insurance information to avoid denials.

Step 8: Track and Audit Claims

  • Monitor reimbursement and claim status.
  • Address denials or rejections promptly with corrected claims and documentation.
  • Perform regular audits to ensure ongoing compliance.

Step 9: Educate Your Staff

  • Train all clinical and billing staff on telehealth coding, compliance, and documentation standards.
  • Update protocols as regulations and payer policies change.

Step 10: Continuously Review and Improve

  • Keep up-to-date with AMA CPT updates, CMS guidance, and payer policies.
  • Collect feedback from patients and staff to improve the telehealth experience.
  • Implement quality improvement initiatives to optimize efficiency and compliance.

Final Thoughts

Telehealth has become an integral part of healthcare delivery. Understanding the nuances of telehealth billing and compliance is essential for providers to ensure accurate reimbursement and adherence to regulations. Stay informed, stay compliant, and continue to provide quality care to your patients.


Call to Action

Stay ahead in the evolving landscape of telehealth by engaging with industry updates, participating in webinars, and collaborating with peers. Your proactive approach ensures that you remain compliant and continue to deliver exceptional care.


References

  1. AMA Telehealth Policy, Coding & Payment
  2. Telehealth Billing in 2025
  3. Telehealth Evaluation and Management (E/M) Services for 2025

Hashtags

#Telehealth #MedicalBilling #Compliance #CPTCodes #HealthcareReimbursement #Telemedicine #MedicalCoding #HealthcareCompliance #Telehealth2025 #MedicalPractice


About the Author

Dr. Daniel Cham is a physician and medical consultant specializing in medical technology, healthcare management, and medical billing. He focuses on delivering practical insights to help professionals navigate complex challenges at the intersection of healthcare and medical practice. Connect with Dr. Cham on LinkedIn to learn more: linkedin.com/in/daniel-cham-md-669036285

 

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