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Specialty Billing

Telehealth Billing Services

Telehealth billing turns on details most billers miss: choosing POS 02 versus POS 10 changes what you get paid, modifier 95 and 93 rules vary by payer, and parity laws differ in every state. MedTaskly's certified coders track each payer's telehealth policy so your virtual visits pay like they should.

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Quick Answer

Why are my telehealth claims paying less than my in-office visits for the same CPT codes?

Usually because of the place-of-service code. Medicare pays POS 02 (telehealth, patient not at home) at the lower facility rate, while POS 10 (telehealth, patient at home) pays the full non-facility rate. Billing POS 02 for a home-based visit can cut reimbursement on a 99214 by 10 to 15 percent. Commercial payers add their own modifier 95 and parity rules, so payment varies payer by payer.

Why It Matters

Why Telehealth Visits Quietly Pay Less Than They Should

Small POS and modifier errors compound into large annual revenue losses.

Telehealth reimbursement hinges on coding choices that look interchangeable but are not. POS 10 tells Medicare the patient was at home and pays the full non-facility rate; POS 02 pays the lower facility rate, so defaulting to POS 02 quietly shaves revenue off every home-based visit. Modifier 95 is required by many commercial payers on the same claims, audio-only encounters need modifier 93 or codes 98008 through 98015, and each state's parity law decides whether a payer must match in-person rates at all.

The complications keep stacking: interstate licensure limits which patient locations you can even bill for, and controlled-substance prescribing rules can make an otherwise routine virtual visit non-billable if the telehealth encounter does not meet DEA requirements. MedTaskly's AAPC-certified coders maintain payer-by-payer telehealth grids covering POS, modifier, and parity rules for all 50 states, which is how we sustain a 98% clean-claim rate across 1,500+ providers. You see the difference in first-pass payments, not appeals.

What We Handle

End-to-end telehealth billing revenue cycle

POS 02 vs POS 10 Accuracy
We assign the correct place-of-service code for every visit so home-based telehealth pays the full non-facility rate.
Modifier 95 and 93 Logic
Payer-specific modifier rules applied automatically, including modifier 93 and audio-only codes when video is not used.
Payer Parity Tracking
We monitor state parity laws and commercial payer telehealth policies so you bill the highest allowable rate everywhere.
Licensure-Aware Claim Scrubbing
Claims checked against provider licensure and patient location before submission, preventing interstate denials that rarely survive appeal.
Controlled-Substance Visit Review
Encounters involving prescribing are screened against DEA telehealth rules so billable visits stay billable and compliant.
Denial Management and Appeals
Telehealth-specific denial workflows recover POS, modifier, and coverage rejections fast, with root-cause fixes to stop repeats.
FAQ

Telehealth Billing Services — questions answered

What codes and modifiers do telehealth claims require?
Most video visits use standard E/M codes like 99212 through 99215 with POS 10 for patients at home, POS 02 otherwise, and modifier 95 for many commercial payers. Audio-only visits use modifier 93 or the dedicated telephone E/M codes 98008 through 98015. The exact combination depends on the payer, which is why a one-size-fits-all setup causes denials.
Why do telehealth claims get denied so often?
The top causes are wrong place-of-service codes, missing or misapplied modifiers 95 and 93, services a specific payer does not cover via telehealth, and provider licensure mismatches when the patient is in another state. Each payer publishes its own telehealth policy, so a claim setup that works for Medicare can fail with a commercial plan.
Do commercial payers have to pay telehealth at in-person rates?
Only where state parity laws require it, and those laws vary widely. Some states mandate payment parity, others only coverage parity, meaning the payer must cover the service but can pay less. We track each state's rules and each payer's policy so your fee schedule expectations and appeals are grounded in what the payer actually owes.
Can you bill telehealth visits where controlled substances are prescribed?
Yes, when the encounter meets DEA telehealth prescribing requirements, which currently allow many prescriptions via telehealth under extended flexibilities but impose stricter rules for certain schedules. We flag prescribing encounters during charge review so the visit is documented and billed compliantly, protecting both the reimbursement and the provider's registration.

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