Telehealth billing has stabilized post-pandemic, but the rules vary widely by payer and state. Here's the framework we use at Billorarcm Services LLC.
Place of Service Codes
POS 02 for telehealth provided outside the patient's home and POS 10 for telehealth provided in the patient's home. Get this wrong and you'll see denials.
Modifiers
Modifier 95 for synchronous audio-video, modifier 93 for audio-only when permitted. Confirm payer policy.
Audio-Only Telehealth
For behavioral health, audio-only is permanently covered by Medicare. For other specialties, check payer policy.
State Licensure
Telehealth crosses state lines, but state licensure rules still apply. Confirm the patient is in a state where the provider is licensed.
Contact us for help building a compliant telehealth billing workflow.