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Telehealth billing for virtual-first and hybrid practices
Billing for virtual care across specialties: the right place-of-service code, modifiers by payer, audio-only rules and more.
How telehealth billing works
Telehealth visits are usually billed with the same CPT codes as in-person visits. The place of service shows where the patient was: POS 10 for the patient’s home and POS 02 for other locations. Many commercial and Medicaid plans also require modifier 95 for audio-video and 93 for audio-only visits.
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Medicare telehealth rules have changed several times in recent years, so we check the rule in effect on each date of service.
Codes we bill every day
| Code | What it covers |
|---|---|
| POS 10 | Patient at home |
| POS 02 | Patient not at home |
| Modifier 95 | Audio-video telehealth (plan-specific) |
| Modifier 93 | Audio-only telehealth (plan-specific) |
| 98966–98968 | Telephone assessment by qualified non-physician professionals |
| 99421–99423 | Online digital E/M (patient portal), by time over 7 days |
Code descriptions are summarized. Payer coverage and documentation rules vary by plan and state.
Denials we prevent
- POS that does not match where the patient was
- Modifier required by one payer and rejected by another
- Provider not licensed in the patient’s state
- Services not on a payer’s telehealth list
- Audio-only visits billed to plans that exclude them
Payer rules to watch
We keep a payer-by-payer telehealth matrix for your practice: which services are covered, which POS and modifiers each payer wants, and whether audio-only is allowed.
Questions about telehealth billing
Do you bill virtual check-ins and portal visits?
Yes, including online digital E/M and telephone codes where payers cover them.
Get a free telehealth billing audit
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.