How Do You Bill Telehealth Visits?

How Do You Bill a Telehealth Visit?

Bill the same CPT or HCPCS code you would use in person, add the telehealth place of service code, and add only the modifiers the payer requires. For Medicare Part B professional claims, CMS tells billers to submit the appropriate CPT or HCPCS code with place of service 02 or 10, and CMS eliminated the GT modifier for telehealth in a transmittal effective January 2, 2018.

The dates matter this year. The CMS Telehealth FAQ updated October 8, 2026 says the current flexibilities run through December 31, 2027, and several billing details change on January 1, 2027 and January 1, 2028. Everything in this post about Medicare rules is stated as of that FAQ.

1. Check that the code is on the Medicare telehealth services list. CMS changes the list on January 1 of each year through the physician fee schedule rule.
2. Check that the practitioner type may bill Medicare telehealth. Physicians, nurse practitioners, physician assistants, clinical psychologists, clinical social workers and others are listed in the CMS MLN booklet.
3. Record where the patient was. At home or somewhere else decides the place of service code.
4. Enter place of service 02 or 10 on the CMS-1500 in item 24B.
5. Add a modifier only when the payer asks for one, such as 93 for audio-only.
6. Send the claim to the payer that covers the visit: your MAC for Medicare, the plan for everyone else.

Which Place of Service Code Do You Use for Telehealth?

Use POS 10 when the patient is in a private residence and POS 02 when the patient is anywhere else. The CMS Telehealth FAQ, answer 8, says physicians and practitioners use POS 02 for telehealth other than in the patient's home and POS 10 for telehealth in the patient's home.

The place of service codes page lists the rest of the code set. A visit that happened on a video call should not carry the clinic's own code, so check what the electronic health record defaults to.

What Does Medicare Allow Now, and When Does That Change?

Medicare allows telehealth at home through December 31, 2027 for most services, and the rules tighten on January 1, 2028. These rows come from the CMS Telehealth FAQ updated October 8, 2026.

Behavioral health follows its own track. The FAQ says geographic and place of service limits for behavioral telehealth were removed permanently, and the in-person visit requirement applies only from 2028. The mental health billing post covers that case.

Which Modifiers Go on a Telehealth Claim?

Fewer than most billers expect. On a Medicare professional claim the place of service code identifies the visit as telehealth. The modifiers below apply only in specific situations.

• Modifier 93, audio-only. Under 42 CFR 410.78(a)(3), the modifier 93 must be appended when a telehealth service is furnished by two-way, real-time audio-only technology. Rural health clinics and FQHCs add Medicare modifier FQ.
• Modifiers BB and BC from January 1, 2027. The FAQ describes BB as for telehealth through a virtual platform operated by an entity that contracts with the practitioner, or has a payment arrangement with them, and BC as for telehealth incident to the practitioner's professional service.
• Modifier 95. The MLN booklet uses it for outpatient therapy telehealth by hospital-employed physical, occupational and speech-language therapists on institutional claims.
• GT. Critical access hospital Method II institutional claims use it. The GT modifier page has the detail.
• GQ. For asynchronous telehealth from the federal demonstrations in Alaska and Hawaii only.

Commercial payers differ. UnitedHealthcare's commercial policy 2026R0046A pays covered telehealth reported with POS 02 or 10, says modifiers 95, GT, GQ and G0 are not required but are accepted as informational, and requires modifier 93 for audio-only services on its list. That is one payer. Read each payer's own policy for your top five, and keep the answers in one table.

What Does a Telehealth Claim Line Look Like?

The modifier that marks a separately identifiable visit on the day of a procedure is a different question, covered on the modifier 25 page.

What About Originating Site Fees, Medicaid and Filing Limits?

The originating site fee is separate. HCPCS Q3014 is the telehealth originating site facility fee, and the MLN booklet says payment is 80% of the lesser of the actual charge or $31.85 for calendar year 2026 services. It is the originating site's facility fee, a separate line from the practitioner's visit.

Do not assume Medicaid copies Medicare. Read the state Medicaid manual and the Medicaid payer page for your state. The Medicare payer page covers the program basics.

Filing limits do not change for telehealth. A late telehealth claim is still a late claim, and the timely filing limits page lists the deadline by payer.

What Should You Check Before a Telehealth Claim Goes Out?

• The place of service matches where the patient was, not where the practice is.
• The practitioner type and the code are on the payer's telehealth list.
• Audio-only visits carry modifier 93 where the payer requires it.
• The date of service falls under the rule you applied, since several Medicare rules change on January 1, 2027 and January 1, 2028.
• The note records the platform, the patient's location and the practitioner's location.
• Family medicine and primary care visits, the largest telehealth group in many practices, are covered on the family medicine billing page.

How Nucleus Align Handles It

Our medical billing team builds place of service and modifier rules for each payer into claim review, with multiple scrubbing rules running before submission and claims sent within 24 hours of charge entry. Book a call to set up your payer table, or browse the blog.