Telehealth Billing Codes Examples and best practices

As telehealth use stabilizes post‑pandemic, coding correctly is now the biggest lever for revenue and compliance.
For physicians, clinics, and health‑tech platforms like s10.ai, mastering telehealth billing codes examples and best practices is essential to avoid denials, maximize reimbursements, and stay ahead of 2026 CMS and private‑payer rules.

What Are Telehealth Billing Codes (and Why They Matter)?

Telehealth billing codes are standardized CPT, HCPCS, and modifier codes used to bill for remote visits—video, phone, asynchronous, or remote‑monitoring encounters.

They tell payers:

• What service was delivered (e.g., E/M visit, psychotherapy, RPM),
• How it was delivered (synchronous video, audio‑only, asynchronous),
• The Place of Service (POS) and whether consent, medical necessity, and tech meet CMS or payer rules.

Getting this wrong creates:

• 15–25% denial rates for telehealth claims,
• Audit risk and delayed AR days,
• Lost revenue on otherwise billable services.

At s10.ai, our AI medical scribe and phone‑agent tools auto‑suggest correct telehealth CPT codes and modifiers in real time, cutting coding errors and speeding clean‑claims submission.

Telehealth CPT Codes Examples (2026‑Ready)

Most telehealth billing still runs on standard E/M codes, plus modifiers and POS codes.

1. E/M (Evaluation & Management) Telehealth Codes

For video‑based telehealth, use standard E/M codes with telehealth billing modifiers:

• New patient visits: 99202, 99203, 99204, 99205
• Established patient visits: 99212, 99213, 99214, 99215

Best practice pattern:
99213‑95‑POS10

• CPT 99213: Established patient E/M, moderate complexity
• Modifier 95: Synchronous telehealth
• POS 10: Telehealth from patient’s home

Most major payers—including Medicare—now reimburse these at the same rate as in‑person visits for covered telehealth services.

2. Behavioral Health & Mental Health Codes

Behavioral telehealth is one of the most active and payer‑friendly niches.

Common codes include:

• 90834: 45‑minute psychotherapy
• 90837: 60‑minute psychotherapy
• 90791: Psychiatric diagnostic evaluation

CMS notes:

• Behavioral and mental health telehealth can be done from the patient’s home.
• Audio‑only telehealth is allowed for behavioral services under certain conditions.

3. Audio‑Only and Brief Communication Codes

Audio‑only telehealth no longer relies on emergency flexibilities; it’s permanently coded under new rules.

Key codes:

• 99441–99443: Telephone E/M (5–30 minutes)
• G2012: Brief communication technology‑based service (virtual check‑in)

2026 insight:

• 99441–99443 are permanently on the Medicare telehealth list, but with lower relative value than video E/M.
• G2012 is great for pre‑visit check‑ins or post‑visit follow‑ups without a full E/M visit.

4. Remote Patient Monitoring (RPM) and RTM

Remote monitoring is increasingly tied to telehealth strategy, especially for chronic‑care and behavioral‑health practices.

Key components:

• 99453–99456: RPM setup, device supply, and data‑collection services
• 99457–99458: RPM treatment management (20+ minutes over 30 days)
• 98975–98981: Remote Therapeutic Monitoring (RTM) for musculoskeletal/respiratory and behavioral health

Best practice:

• RPM requires medically reasonable and necessary chronic or acute conditions and patient consent.
• Only one practitioner can bill RPM per patient in a 30‑day period.

Telehealth Billing Modifiers and Place‑of‑Service Codes

Modifiers and POS codes are non‑negotiable for clean telehealth billing.

Telehealth Modifiers (2026)

• ‑95: Synchronous telehealth (two‑way audio‑video)
• ‑93: Synchronous audio‑only (for eligible services)
• ‑GQ: For asynchronous telehealth (e.g., Alaska/Hawaii federal telemedicine demos)
• ‑GT: Historically used for telehealth; now largely superseded but still appears in some institutional settings

Use ‑95 or ‑93 in addition to the correct CPT code when billing telehealth.

Place of Service (POS) Codes

• POS 02: Telehealth provided other than in the patient’s home (e.g., clinic‑to‑clinic, school‑based telehealth)
• POS 10: Telehealth provided from the patient’s home (residential setting)

Example bundle:
99213‑95‑POS10 = 15‑minute established patient telehealth visit from home, reimbursed at the non‑facility E/M rate.

Telehealth Billing Best Practices for 2026

To rank #1, your content must solve real billing pain points while signaling expertise and trust (E‑E‑A‑T).

1. Use Standardized E/M Coding (Time vs. MDM)

Telehealth E/M visits must be coded the same way as in‑person visits:

• Either by medical decision‑making (MDM),
• Or by total time (≥50% of visit for counseling/coordination).

Best practice:

• Document start/stop times and medical necessity for every telehealth visit.
• Use structured templates (like s10.ai’s AI scribe notes) to capture history, exam, and plan so coding aligns with guidelines.

2. Follow CMS and Payer Telehealth Rules

CMS telehealth policy is no longer “emergency mode.”

Key 2026 points:

• Patients can receive telehealth at home only for mental health, SUD, Home‑dialysis ESRD, and acute stroke.
• All telehealth services added to the Medicare telehealth services list are now considered permanent.

Best practice:

• Build a telehealth services checklist (office visits, follow‑ups, RPM, behavioral health) and audit it quarterly.
• Link to official CMS and HHS telehealth guidance on your page for authority.

3. Consent, Documentation, and Tech Requirements

Telehealth isn’t just a code change; it’s a workflow change.

Must‑do list:

• Obtain patient consent for telehealth and store it in the EHR.
• Use HIPAA‑compliant platforms (e.g., Doxy.me, Zoom for Healthcare).
• Document:
  • Chief complaint,
  • Technology used (video vs. audio),
  • Whether patient is at home or at an originating site,
  • Any follow‑up plan.

4. Avoid Common Telehealth Billing Traps

• Billing in‑person and telehealth for the same visit in the same 24‑hour window.
• Using telehealth modifiers on non‑telehealth visits.
• Misusing POS codes (e.g., POS 02 when the patient is clearly at home).

Best practice:

• Conduct quarterly audits of 10–20 telehealth claims to catch patterns.
• Use AI‑assisted coding tools (like s10.ai) to flag inconsistencies before billing.

Why s10.ai Is the Ideal Telehealth Billing Partner

Practices that pair telehealth billing best practices with AI‑powered automation often see:

• 20–40% reductions in coding errors,
• 25%+ uptick in clean‑claims ratio,
• Faster AR days (under 30 days in many high‑volume clinics).

With s10.ai, you get:

• An AI medical scribe that listens to encounters and auto‑generates structured notes aligned with E/M, telehealth, and RPM guidelines.
• An AI phone agent that routes calls, captures chief complaint, and prepares the visit for correct coding.
• Built‑in telehealth code suggestions (CPT, modifiers, POS) that reduce manual lookup and human error.