Telehealth billing has become a permanent part of the healthcare billing landscape. The rules governing what is covered, how to code it, and what documentation is required continue to evolve. CMS publishes current telehealth coverage rules annually, and billing telehealth incorrectly is one of the fastest ways to generate a denial wave, because payer rules for virtual care vary more widely than almost any other service category.
This guide covers the CPT codes used for telehealth visits, place of service requirements, payer-specific differences, and the documentation standards that support compliant billing. For mental and behavioral health telehealth specifics, see our mental health billing services.
Telehealth CPT Codes
Evaluation and Management (E/M) visits delivered via telehealth use the same CPT codes as in-person visits: 99202-99215 for office visits, depending on medical decision making or total time. Psychiatric telehealth uses codes 90832-90837 for psychotherapy, see our psychiatry billing services. Telephone visits (audio-only) use codes 99441-99443. Not all payers reimburse audio-only at the same rate as video visits.
Place of Service Codes for Telehealth
For telehealth, two POS codes are commonly used: POS 02 (Telehealth Provided Other than in Patient Home) and POS 10 (Telehealth Provided in Patient Home). CMS provides current POS code guidance for all telehealth scenarios. The POS code determines which fee schedule applies, so using the wrong code affects payment rates, not just compliance.
Payer-Specific Telehealth Rules
- Medicare: Covers telehealth under flexibilities described at qpp.cms.gov; requires POS 02 or 10 depending on patient location.
- Florida Medicaid: Covers telehealth under Florida Statutes Section 456.47; administered through AHCA; managed care plan rules may differ.
- Commercial payers: UHC, Aetna, Cigna, BCBS, and Humana each have separate telehealth coverage policies; our payer-specific billing services handle these variations.
Documentation Requirements for Telehealth
Telehealth visit documentation must meet the same E/M documentation standards as in-person visits. Additionally, the record should indicate that the service was delivered via telehealth, identify the technology platform used, confirm that the patient consented, and note the patient location.
Key Takeaways
- Telehealth E/M visits use the same CPT codes as in-person visits; POS code communicates the telehealth context.
- POS 02 applies when the patient is at a telehealth originating site; POS 10 applies when the patient is at home.
- Audio-only visits use 99441-99443 and are reimbursed at different rates than video visits.
- Payer rules for telehealth vary significantly, our payer-specific billing handles each plan separately.
- Telehealth documentation must additionally document the modality, consent, and patient location.
Frequently Asked Questions
Do telehealth visits require a special modifier?
CMS no longer requires the 95 modifier for most telehealth services under current flexibilities, but some commercial payers still require it. Our payer-specific billing team verifies current modifier requirements for each payer before billing.
Are mental health telehealth visits billed differently?
Yes. Psychiatric telehealth may use psychotherapy CPT codes (90832-90837) rather than E/M codes. See our mental and behavioral health billing and psychiatry billing services for specialty-specific guidance.
Can a provider bill for a phone call with a patient?
Audio-only telephone visits are billable using CPT codes 99441 (5-10 minutes), 99442 (11-20 minutes), or 99443 (21-30 minutes). Coverage and reimbursement rates vary by payer, confirm through our payer billing services.