Telehealth has transformed the way healthcare providers deliver care—and how they get paid. But with new opportunities come new challenges. Many practices struggle with telehealth billing guidelines, payer requirements, and reimbursement delays.

At Velora Medical Billing, we help providers navigate the complexity of telehealth reimbursement so they can focus on patient care without losing revenue. If you’re offering virtual visits, here are the best practices to ensure you get paid accurately and on time.

Why Telehealth Billing Is So Tricky

Telehealth became mainstream during the COVID-19 pandemic, but billing for virtual visits is still confusing due to:

  • Inconsistent rules between payers
  • Constantly changing guidelines
  • Confusion about place of service (POS), modifiers, and codes

Missing any of these can lead to claim denials or underpayments.

Stay Updated on Payer Policies

One of the most important best practices is staying current with each payer’s telehealth rules. Medicare, Medicaid, and private insurers often have different policies.

Check These Frequently:

  • Approved CPT and HCPCS codes for telehealth
  • Allowed platforms (audio-only vs. video)
  • Reimbursement rates vs. in-person visits
  • Licensing and location requirements

Tip: Assign a team member or partner with a billing company like Velora to monitor updates regularly from CMS and private insurers.

Use the Correct CPT Codes

Using the right billing codes is crucial for accurate telehealth reimbursement. Many standard E/M (Evaluation and Management) codes can be used, but not all are reimbursed equally.

Commonly Accepted CPT Codes for Telehealth:

  • 99201–99215: Office visits (audio/video)
  • 99421–99423: Online digital E/M services
  • 99441–99443: Telephone E/M services (audio-only)

Double-check if your payer accepts these codes and what level of documentation is required.

Don’t Forget Modifiers and POS Codes

This is where many practices get it wrong. Payers often require specific modifiers and place of service codes to indicate that the visit was conducted virtually.

Best Practices:

  • Use Modifier 95 for real-time audio-video telehealth services
  • Use Place of Service (POS) 10 for telehealth provided at home
  • Use POS 02 if the patient is in a different medical setting

Incorrect use of modifiers or POS codes can result in denials or reduced payments.

Ensure Accurate Documentation

Just because the visit is virtual doesn’t mean documentation is optional. Payers still require the same level of detail as in-person visits.

Document:

  • Patient consent for a telehealth visit
  • Mode of communication used (audio/video or phone)
  • Duration of the visit
  • Medical necessity and decision-making details

Good documentation not only supports the claim but protects your practice during audits.

Verify Telehealth Eligibility Before Every Visit

Not all insurance plans cover telehealth—or they may cover it under limited conditions. It’s crucial to verify eligibility every time.

What to Verify:

  • Is the service covered as telehealth?
  • Are there co-pays or deductibles?
  • Are prior authorizations required?

This step reduces the risk of post-visit billing surprises for both your practice and your patients.

Don’t Overlook Patient Responsibility

With virtual care, patients often assume insurance covers everything. That’s not always true. Make sure your staff explains coverage and collects co-pays or out-of-pocket amounts upfront when possible.

  • Offer online payment options
  • Send electronic invoices
  • Provide clear billing communication

Patients who understand the charges are more likely to pay—and pay faster.

Train Your Team on Telehealth Billing

Your staff is your first line of defense against billing errors. Make sure they understand telehealth workflows, documentation requirements, and common payer rules.

Areas to Train:

  • Scheduling and appointment labeling
  • Verification scripts for telehealth eligibility
  • Coding and modifier usage
  • Handling denials related to virtual visits

At Velora, we offer training and support to help front-desk and billing staff stay sharp.

Outsourcing Telehealth Billing: A Smart Move

Telehealth billing is detailed and time-sensitive. Outsourcing this process to a specialized billing company like Velora ensures you stay compliant and get paid faster.

With Velora, you get:

  • Up-to-date knowledge of telehealth billing rules
  • Real-time denial tracking and appeals
  • Faster, cleaner claims submission
  • Transparent reporting and analytics

We help you turn virtual visits into real revenue.

Final Thoughts

Telehealth billing doesn’t have to be frustrating or confusing. By following best practices—verifying coverage, using the right codes and modifiers, and documenting accurately—you can ensure smooth payments and better patient satisfaction.

Need help with how to bill telemedicine correctly?

📞 Contact Velora Medical Billing today for a free consultation.
We’ll help you maximize your virtual care revenue with fewer denials and delays.