Master Telehealth Billing Essentials: A doctor's guide to navigating regulations, codes, and documentation for accurate reimbursement.

1. Telehealth Billing Essentials: What You
Need To Know
The rise of telehealth, the use of telecommunications technology for remote
healthcare delivery, has transformed the way patients access medical services. It
offers convenience, increased accessibility for patients in rural areas, and improved
chronic disease management.
However, telehealth billing presents a unique set of challenges compared to
traditional in-person visits. Here, we will explore the essentials and aspects
of telehealth billing to ensure you get reimbursed accurately for your services.
Understanding the Nuances of
Telehealth Billing
Telehealth billing involves navigating a complex landscape of regulations set by
different payers. Here’s a breakdown of the key players:
 Medicare: The federal health insurance program for seniors has expanded its
coverage for telehealth services in recent years. However, specific requirements
regarding place of service, originating sites, and eligible healthcare professionals
exist.

2.  Medicaid: Each state administers its own Medicaid program, and telehealth
coverage guidelines can vary. It’s crucial to stay updated on your state’s Medicaid
telehealth policies.
 Commercial Insurers: Private insurance companies have varying levels of coverage
for telehealth services. Understanding their specific telehealth billing guidelines is
essential for accurate reimbursement.
As per survey by the American Medical Association, 96% of physicians reported
using telehealth in the past year. This rapid growth necessitates staying informed
about the constantly evolving regulations for telehealth billing at both the federal and
state levels. According to, American Telemedicine Association every state’s medical
licensing board can provide valuable updates.
Key Aspects of Telehealth Billing
1. Verifying Patient Eligibility:
Before any telehealth encounter, confirm your patient’s insurance coverage for
telehealth services. This helps avoid denied claims and potential patient financial
burden.
2. Selecting the Correct Billing Codes:
Telehealth services are billed using specific Healthcare Common Procedure Coding
System (HCPCS) codes or Current Procedural Terminology (CPT) codes. These
codes depend on the type of service provided during the telehealth visit. For
instance, a video consultation with an established patient might use CPT code
99214, while remote patient monitoring could involve HCPCS code G0256.
3. Using Modifiers for Telehealth Services:
Most payers require adding modifiers to the primary billing code to indicate the
telehealth nature of the service. Common modifiers include –
 “GT” for telephone consultations
 “U1” to “UD” for real-time audio-visual consultations
Depending on the duration of the visit.
4. Documentation for Accurate Billing:
Thorough medical record documentation is crucial for accurate telehealth billing. This
includes:
 Patient Consent: Documenting the patient’s informed consent for the telehealth
encounter.
 Telehealth Visit Details: Capture the date, time, and duration of the virtual visit.

3.  Diagnosis and Treatment Plan: Document the diagnosis, and treatment plan
discussed during the telehealth visit.
Additional Considerations in Telehealth Billing
 Place of Service Codes: Payers often require specific place of service codes to
indicate the location where the telehealth service was delivered. Understanding your
state’s regulations around these codes is essential.
 Geographical Restrictions: Some insurance plans may have geographical
restrictions on telehealth coverage. For example, the plan might only cover telehealth
services delivered within the state where the patient resides. Being aware of such
limitations helps avoid claim denials.
 Streamlining the Telehealth Billing Process: Consider using telehealth-specific
billing software to streamline the process. These tools can automate tasks like code
selection, modifier application, and claims submission, improving efficiency and
reducing errors.
Frequently Asked Questions (FAQs) about
Telehealth Billing
Q: How do I bill a telehealth visit differently from an in-
person visit?
A: You’ll use different codes (HCPCS or CPT) and add modifiers (GT, U1-UD) to
indicate it was a telehealth encounter.
Q: Why should consider 24/7 Medical Billing services for
telehealth billing?
A: We can ensure requiring knowledge about the latest rules and maximizing
reimbursement.
Outsource Telehealth Billing
Here’s where a telehealth billing Services Company can become your trusted
partner. 24/7 Medical Billing Services handle the complexities of telehealth billing,
allowing you to focus on what matters most providing excellent care to your patients.
Imagine the time saved, the reduced stress, and the peace of mind of knowing your
practice is getting the full financial benefit of your telehealth services. Contact us
today and see how we can help your practice thrive in the exciting world of
telehealth!
About 24/7 Medical Billing Services:

4. 24/7 Medical Billing Services is the nation’s leading medical billing service provider
catering services to more than 43 specialties across the entire 50 states. You can
rely on us for end-to-end revenue cycle management. We guarantee up to 10-20%
increase in the revenue with cost reduction of your practice for up to 50%.
Call us today at 888-502-0537 to know more on how we can help boost profitability
for your practice.
Media Contact –
24/7 Medical Billing Services,
28405 Osborn Road,
Cleveland, OH, 44140
Tel: + 1 -888-502-0537
Email: info@247medicalbillingservices.com