What are the billing codes for telehealth services?

Billing for telehealth services depends on whether you are billing Medicare or a commercial insurance payer, as coding rules differ.

Medicare and Standard E/M Coding

For Medicare and many traditional insurers, you do not use a unique telemedicine CPT code for standard visits. Instead, you bill standard office or outpatient evaluation and management (E/M) codes:

• New Patients: CPT codes 99202–99205
• Established Patients: CPT codes 99211–99215

To indicate the service was delivered remotely, you must combine these E/M codes with the correct Place of Service (POS) and Modifiers:

• POS 10: Telehealth provided in the patient's home.
• POS 02: Telehealth provided at a location other than the patient's home.
• Modifier 95: Synchronous real-time audio-video interaction (not required if the modality is already clear, but widely used).
• Modifier 93: Synchronous audio-only interaction.

Dedicated Telehealth CPT Codes (98000 Series)

The American Medical Association (AMA) provides a dedicated family of codes (98000–98016) for synchronous audio-video and audio-only E/M services. However, Medicare assigns status indicator "I" to codes 98000–98015 and will deny them, requiring the standard office visit codes listed above. Some commercial and private payers accept this dedicated series:

• Audio-Video E/M Services: CPT 98000–98007 (mirroring new and established patient visit tiers).
• Audio-Only E/M Services: CPT 98008–98015.
• Virtual Check-Ins: CPT 98016 (brief, 5-to-10-minute patient-initiated communication for established patients; this code is paid by Medicare, replacing older HCPCS G-codes).

Digital and Online Services (E-Visits)

• Online Digital E/M: CPT 99421–99423 (patient-initiated digital communications/portal messages handled over a cumulative 7-day period).

Always verify individual commercial, Medicaid Advantage, or private payer guidelines before submission, as their adoption of the 98000 code family and audio-only rules varies. You can review official policy updates directly on the CMS Telehealth List or via Telehealth.HHS.gov.

Telehealth visits are primarily billed using standard office evaluation and management (E/M) codes (99202–99215) or the dedicated telehealth CPT code family (98000–98016), depending on your specific insurance payer.

Standard Office E/M Codes (Medicare and Most Payers)

• New Patient Visits: 99202–99205 (15 to 74 minutes)
• Established Patient Visits: 99211–99215 (5 to 55 minutes)
• Billing Rule: Medicare and many traditional payers require these standard codes paired with a Place of Service code (POS 10 for home or POS 02 for a facility setting) and the correct modifier (such as Modifier 95 for audio-video or Modifier 93 for audio-only). Medicare generally denies the newer dedicated telehealth codes listed below, except for brief check-ins. You can review official primary care guidelines on Telehealth.HHS.gov.

Dedicated Telehealth CPT Code Family (Commercial Payers)

• Audio-Video Visits: 98000–98007 mirror the standard office visit tiers for real-time video encounters.
• Audio-Only Visits: 98008–98015 cover synchronous telephone E/M encounters based on time or medical decision-making.
• Brief Check-Ins: 98016 covers a single 5- to 10-minute patient-initiated virtual check-in (accepted by Medicare as a replacement for older G-codes).

Behavioral Health and Digital Services

• Psychiatric Evaluation: 90791 and 90792
• Psychotherapy: 90832–90853 for various timed and group therapy sessions
• Digital E-Visits: 99421–99423 for online digital evaluations

The American Medical Association's dedicated CPT telehealth family (98000–98016) remains active in 2026 for virtual evaluation and management (E/M) services, though Medicare and commercial payers handle them differently.

New Telehealth CPT Code Family (98000–98016)

The AMA established these codes to mirror the structure of standard office visits, determined by medical decision-making (MDM) or total time.

• Audio-Video Codes (98000–98007): Synchronous real-time audio and video visits for new patients (98000–98003) and established patients (98004–98007).
• Audio-Only Codes (98008–98015): Synchronous audio-only encounters for new patients (98008–98011) and established patients (98012–98015), replacing older deleted telephone codes (99441–99443).
• Brief Virtual Check-In (98016): Patient-initiated brief communication for established patients, replacing HCPCS code G2012.

Payer Rules: Medicare vs. Commercial

• Medicare Fee-For-Service: Medicare denies most of the dedicated 98000–98015 range. Instead, providers must bill standard office visit codes (99202–99215) with the appropriate place of service (POS) and modifier (95 for audio-video, 93 for audio-only). Code 98016 is the only exception from the new family that Medicare accepts for brief check-ins.
• Commercial and Medicaid Payers: Many commercial plans accept the dedicated 98000–98016 series, though specific coverage and reimbursement rates vary by contract.

Place of Service (POS) and Modifiers

• POS 10: Patient's home (reimbursed at the higher non-facility rate).
• POS 02: Location other than home (reimbursed at the facility rate).
• Modifier 95: Synchronous audio-video (used when billing standard E/M codes for virtual care to payers requiring it).
• Modifier 93: Synchronous audio-only (telephone).

Coding guidelines for telehealth services require using standard office visit codes paired with specific Place of Service (POS) codes and modifiers to denote remote care.

Standard Evaluation and Management (E/M) Codes

• New Patients: Use CPT codes 99202–99205 for synchronous (real-time) audio-video visits.
• Established Patients: Use CPT codes 99211–99215 for standard remote visits.
• Note: Medicare and many major payers consider the dedicated AMA telemedicine series (CPT 98000–98015) invalid for standard E/M reimbursement, though some commercial plans accept them.

Place of Service (POS) Codes

• POS 10 (Home): Use when the patient is located in their home; typically yields the higher non-facility payment rate.
• POS 02 (Telehealth Other than Home): Use when the patient is located in a setting other than their home (like another clinic site).

Telehealth Modifiers

• Modifier 95: Appended for synchronous real-time audio-video interactive telecommunications.
• Modifier 93: Appended for synchronous audio-only (telephone) services where allowed.

Virtual Check-Ins and E-Visits

• 98016: Brief, patient-initiated virtual check-in for established patients (5–10 minutes), replacing older HCPCS G-codes.
• 99421–99423: Online digital E-visits managed through a patient portal over a cumulative 7-day period.

Billing telehealth services requires standard CPT or HCPCS procedure codes paired with the correct Place of Service (POS) code and modifiers based on the type of technology used.

Choose the Right Codes

• Standard E/M Codes: Use regular office or outpatient evaluation and management codes (such as CPT 99202–99205 and 99211–99215) for real-time audio-video visits.
• Audio-Only Codes: Use specific code sets designated for phone-only interactions if video is not available or not consented to.
• Virtual Check-ins: Use digital e-visit or communication technology-based service codes (like CPT 99421–99423) for online evaluations.

Set the Place of Service (POS)

• POS 10: Use this when the patient is located in their home.
• POS 02: Use this when the patient is located in a location other than their home (such as an office or public space).
• Note: Traditional in-person codes like POS 11 are generally invalid for remote telehealth billing.

Add Required Modifiers

• Modifier 93: Append this for audio-only synchronous telehealth services.
• Modifier 95 / GT: Used by some commercial or specific non-Medicare payers to designate real-time interactive audio-video telemedicine. Medicare typically does not require a modifier for standard audio-video claims if the correct POS is used.

Check Payer Rules

• Medicare: Follows specific federal guidelines for distant and originating site payments, which are regularly updated via the Centers for Medicare & Medicaid Services.
• Medicaid and Private Insurance: Policies, allowable codes, and parity rates vary widely by state and individual commercial contract. Always verify coverage guidelines directly with the specific payer.