2025 Useful Telemedicine CPT Codes

Telehealth Billing & 2025 Telemedicine CPT Code Updates

Contributions By Abid H.

Telehealth billing guidelines 2025 bring some real changes that billing staff and providers need to pay attention to. If you’re working with claims for primary care or mental health services done remotely, you’ll need to follow updated rules to avoid denials or payment issues.

New telehealth CPT codes are now used for both video and audio-only visits. Medicare no longer accepts the old telephone codes, and some commercial payers are making similar changes. Time and medical decision-making now play a bigger role in choosing the right code. Using the right place of service code — POS 02 or POS 10 — is also part of clean claim submission.

Modifiers still apply. Modifier 95 is standard for many video visits. GT is still accepted by some private insurers, but not all. The key is checking what each payer wants.

Telehealth Billing Guidelines 2025

Billing rules for telehealth in 2025 are more structured than before. Practices need to follow updated instructions when submitting claims, especially for services done outside the clinic. Below are the main points to keep in mind:

• Video and phone visits are billed differently
  New CPT codes apply based on how the visit was delivered. Use codes for audio-video or audio-only, depending on the setup.
• Choose codes based on time or medical decision-making
  Documentation must clearly show which method was used to support the level of service.
• Use of modifiers is still required
  • Modifier 95 is typically used for real-time video visits.
  • Modifier GT may still be accepted by some private insurers.
  • Always verify modifier requirements with each payer.
• Telehealth place of service code (POS) must match the patient’s location
  • POS 02 is used when the patient is outside their home.
  • POS 10 is used when the patient is at home during the visit.
• Audio-only services come with extra conditions
  These require a clear note explaining why video wasn’t used and must meet the minimum time requirement.
• Check payer-specific rules regularly
  Medicare and commercial payers may handle codes, modifiers, and POS differently. Don’t assume one policy fits all.
• Incorrect billing leads to denials or delays
  Small errors in documentation, modifier use, or POS selection can result in claims being rejected.

2025 Telehealth CPT Codes

CPT codes used for telehealth have changed. The codes that were used for phone visits in past years — 99441 through 99443 — are no longer accepted by Medicare. Instead, there’s a new set of codes that cover both video and phone visits. They follow the same structure as in-person E/M codes but are built specifically for remote care.

Video Visits

These codes apply when the visit is done over real-time video. They’re broken down by whether the patient is new or established, and by either time spent or how complex the visit was.

• For new patients, use codes 98000 through 98003
• For established patients, use 98004 through 98007

Each code has a minimum number of minutes tied to it. You either bill by total time or by the level of decision-making — whichever is more accurate based on the visit.

Phone visits (audio only)

If the visit was done over the phone with no video, there’s a separate set of codes.

• New patients: 98008 to 98011
• Established patients: 98012 to 98015

These can only be used when video wasn’t possible and the phone call met the required length. Medicare expects at least 10 minutes of active medical discussion. A quick follow-up or message wouldn’t qualify.

Quick check-ins

Code 98016 is now used for short communications, like a brief call to check in on an existing issue. It replaces the old G2012 code. The call has to be between 5 to 10 minutes and can’t be tied to a visit that just happened or one that’s about to happen.

How Telehealth Billing Works in Common Visit Types

Many practices using telehealth are delivering care in two areas more than any other: routine primary care and mental health. These visit types are often handled remotely and have specific billing considerations tied to them.

Primary care visits (remote)

• Often include follow-ups, medication reviews, new symptoms, or chronic condition check-ins
• Code selection depends on time or complexity — whichever is more accurate
• For video visits, use the appropriate CPT code from the audio-video range
• If a phone visit was done, check that the payer allows audio-only billing and that the time requirement was met
• Documentation must clearly support the code used, especially when billing based on time

Mental Health Services (remote)

• Includes therapy sessions, psychiatric consultations, medication adjustments, and behavioral health check-ins
• Many payers allow phone-only visits for mental health, but not all — always confirm
• Session time is usually the deciding factor for code selection
• Some mental health visits may still require older CPT codes with proper modifiers
• Notes must reflect the mode of communication and time spent

Not every service can be billed the same way under telehealth. What works for one payer may not apply to another. Before submitting claims, confirm that the service qualifies for remote billing under that plan’s policy.

What Modifiers and POS Codes Should You Use for Telehealth?

Every telehealth claim needs the right modifier and place of service code. If either one is missing or used wrong, the claim can get delayed or denied — even if the rest of the info is correct.

Modifiers

• Modifier 95 is used for live video visits. Most payers recognize it, and it’s required on many claims when the visit is done through real-time audio and video.
• Modifier GT means the same thing but is mostly used by private payers. Medicare doesn’t accept it anymore, but some commercial plans still do.

Payers don’t all follow the same rules, so you’ll need to check each one before choosing which modifier to use.

POS Codes

• POS 02 is used when the patient is not at home during the visit. That could mean a clinic, school, or another facility.
• POS 10 is for visits done while the patient is at home. It’s used more often now, especially for mental health and primary care.

These codes are important because they help the payer understand where the service happened — and they can affect payment rates.

Always make sure your modifier and POS code match the visit. A mismatch can lead to denials that take extra time to fix.

Where to Keep Track of Updates

Billing rules for telehealth can shift without much notice. It’s a good idea to regularly check payer portals and stay in touch with teams who monitor updates and documentation requirements across services and codes.

Some clinics refer to Certified Healthcare Billing for support when coding changes or modifier use isn’t clear. Having a reliable reference can help avoid delays and reduce the back-and-forth that often comes with rejected or flagged claims.

Final Thoughts

Following the updated telehealth billing guidelines 2025 isn’t just about codes — it’s about keeping your billing clean and avoiding preventable errors. Even small mistakes can hold up payments or trigger unnecessary rework.

As more services shift online, understanding virtual visit billing rules helps practices get paid on time and stay compliant. Always double-check code use, modifiers, and payer instructions. Keeping things simple and accurate goes a long way in this space.