Key takeaways
- Most telehealth visits still use the same office E/M codes (99202–99215), paired with the correct modifier and place-of-service code.
- Modifier 95 signals a synchronous audio-video visit; place-of-service 10 (patient home) and 02 (other location) tell the payer where care happened.
- Audio-only visits have their own coding path and payer-specific rules — never assume parity with video.
- Most telehealth denials come from missing modifiers, wrong POS, or a payer policy the front desk never verified.
Telehealth coding basics
Telehealth billing is less about exotic codes and more about pairing the right familiar code with the right modifier and place-of-service value. In most cases you bill the same evaluation and management (E/M) code you would for an in-person visit, then add the data points that tell the payer the encounter happened virtually.
The three things every clean telehealth claim needs are: the correct CPT/HCPCS code for the service, a telehealth modifier (most often 95), and an accurate place-of-service (POS) code. Get any one of those wrong and the claim is at risk.
Common telehealth CPT codes
These are the codes practices use most often for virtual encounters in 2026.
| Code(s) | Description | Typical use |
|---|---|---|
| 99202–99205 | New patient office/outpatient E/M | First virtual visit with a new patient |
| 99212–99215 | Established patient office/outpatient E/M | Follow-up virtual visits |
| 99441–99443 | Telephone (audio-only) E/M | Phone-only assessment, payer permitting |
| G2012 | Brief virtual check-in | 5–10 minute established-patient check-in |
| G2010 | Remote evaluation of recorded images/video | Store-and-forward review |
Always confirm whether a payer recognizes the audio-only telephone codes (99441–99443) for the date of service. Coverage for these has shifted repeatedly since 2020 and varies by plan.
Modifiers and place of service
Modifiers and POS codes are where most telehealth claims succeed or fail.
- Modifier 95 — synchronous (real-time) audio-and-video telemedicine. This is the most common telehealth modifier for commercial payers.
- Modifier 93 — synchronous audio-only service, used where the payer accepts audio-only encounters.
- POS 10 — telehealth provided in the patient's home.
- POS 02 — telehealth provided somewhere other than the patient's home.
Choosing POS 10 versus 02 can change the reimbursement rate, because some payers pay the higher non-facility rate when the patient is at home. Confirm each payer's policy rather than defaulting to one POS for every claim.
Audio-only and the new rules
Audio-only telehealth is the area most likely to cause denials because policy continues to evolve. A video visit that drops to phone-only mid-encounter, for example, may need to be coded differently than a planned telephone visit. Document the modality clearly in the note, and code to what actually happened — not what was scheduled.
How to avoid telehealth denials
Telehealth denials are overwhelmingly preventable. The highest-yield fixes are operational, not clinical.
- Verify telehealth coverage at scheduling. Confirm the payer covers the modality and code before the visit, not after the denial.
- Standardize your modifier + POS logic. Build a simple rule the front desk and billers both follow so claims are consistent.
- Document modality and time. Note whether the visit was audio-video or audio-only and the total time when time-based coding applies.
- Watch payer bulletins. Telehealth rules change often; assign one person to track updates from your top payers.
If telehealth denials are eating into your collections, a focused review of your modifier and POS mapping usually recovers revenue fast. Verimedix can audit your telehealth claims and fix the rules driving the denials.
Frequently asked questions
Modifier 95 is the most common, signaling a synchronous audio-and-video telemedicine service. Modifier 93 is used for synchronous audio-only services where the payer accepts them. Always confirm the specific payer's preferred modifier.
Use POS 10 when telehealth is provided in the patient's home and POS 02 when it is provided in another location. The choice can affect reimbursement, so follow each payer's policy.
In most cases yes — codes 99202–99215 are used for both, with the telehealth modifier and correct place-of-service added. Some payers also recognize dedicated audio-only telephone codes (99441–99443).
The most common causes are a missing or wrong modifier, an incorrect place-of-service code, or billing a modality the payer does not cover. Verifying coverage before the visit prevents most of these denials.
Sometimes. Coverage for audio-only visits varies by payer and has changed repeatedly since 2020. Confirm coverage and the correct codes for each payer and date of service before billing.