Is Telehealth Billing Critical?

Telehealth is an old-book story but has been thrown light with the effect of COVID-19. With more rules imposed on telehealth billing, many medical practices have been struggling to balance between their billing, operations, and claims. Therefore, to understand the criticality of telehealth billing, it is viable to know what has changed and what has not, so it becomes easy for practices to know the importance of telehealth billing.

Codes that were implemented on an emergency basis by CMS for immediate service of the public in Telehealth medicine:

  • Using modifier-95 indicates that the service rendered was originally performed via telehealth.
  • If you belong to Hawaii or Alaska, and you are using asynchronous technology (store and forward), use modifier-GQ.
  • All new and old patients can avail telehealth services, and only the codes 99201- 99215 to be used for new patients.
  • CPT code range for telephone services 99441 – 99443, can now be reimbursed by CMS in the following ways:

1.99441 – $14.42, 99442 – $28.15, 99443-$41.14

2. Rest of the rules remain to be the same and the only change is these are covered by CMS and Medicaid.

What remains unchanged in Telehealth Billing?

The natural way of providing the telehealth service has not changed. The code that allows physicians to initiate a codable or billable encounter is G2012 – the virtual check-in code. The rest of the codes along with these updated changes, anyhow require the encounter to be initiated from the patient end.

The rules that were imposed in 2018 on physician’s fees schedule in a way of modernizing the healthcare system by using technology, reducing administrative burden, and enhancing the patient-doctor relationship is given clarity this time, with letting know the restrictive and relaxation of rules as well. Moreover, new legislation covers several provisions, in which HHS (Health & Human Services) guide waiving specific rules related to the provision of telehealthcare services.

What has changed in Telehealth billing?

It is an old-classroom rule that in rural areas that are far away from availing regular services, telehealth services may not be covered for such areas, but now has been extended depending on emergencies.

CMS has given relaxation to these rules using a waiver code 1135 stating how and where a provider can render telehealth services. Medicare will now pay for offices, hospitals, and other visits furnished through telehealth throughout the nation that includes the patient’s location of any demography, without any restrictions.

There is a waive-off for federal healthcare programs through telehealth visits by the Office of Inspector General, which is a flexible factor brought in telehealth medicine. During emergencies, there is no need for enforcing HIPAA compliance for all patient communications and allow availing of telehealth services to be provided through everyday communication tools or apps like FaceTime or Skype.

Documenting codes based on these changes

Based on these changes, we have experts who can help you with proper documentation of HCPCS codes such as G2012, G2010, online digital evaluations, along with the duration of the telehealth service and how much will the physician or practice be paid for the service rendered, and also briefed CPT codes such as 99452, 99451, 99447, 99446, 99448 & 99449 and 99201–99215.


For end-to-end guidance on HCPCS and CPT codes of telehealth medical billing, you need an expert to analyze and audit your pain points and provide you feasible and scalable suggestions such that you can observe the consistency in revenue generation and run a hassle-free operation. Thus, knowing the importance of telehealth billing can help you plan and estimate the bigger picture of how it impacts your practices’ revenue.

Call 24/7 Medical Billing Services, your best and most medical billing partner at +1-888-502-0537 for providing service at your convenience.

Read More: Modifiers for TeleHealth & TeleMedicines

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