Introduction
Telehealth has transformed healthcare delivery — making care more accessible, faster, and smarter. As we move through 2025, telehealth billing continues to evolve with new CPT codes, payer rules, and Medicare updates.
To stay compliant and get paid faster, healthcare organizations must adapt to the latest billing standards and documentation requirements.
In this blog, we’ll explore the key changes, codes, and strategies shaping telehealth billing in 2025.
1. The Rise of New CPT Codes for Telehealth
In 2025, the American Medical Association (AMA) introduced new CPT codes to simplify billing for virtual visits — both audio-video and audio-only.
Here’s the new code breakdown:
| Type | Code Range | Description |
|---|---|---|
| Audio-Video (New Patient) | 98000–98003 | Evaluation via live video for new patients |
| Audio-Video (Established Patient) | 98004–98007 | Virtual follow-up via video |
| Audio-Only (New Patient) | 98008–98011 | Consultation via phone without video |
| Audio-Only (Established Patient) | 98012–98015 | Follow-up call for established patients |
| Communication Technology-Based Service | 98016 | Brief 5–10 minute medical check-in |
These codes are designed to reflect the complexity and duration of telehealth encounters, giving providers a standardized way to bill payers.
2. Medicare’s 2025 Policy Updates
While AMA rolled out the 98000-series, Medicare hasn’t fully adopted them yet. Instead, the Centers for Medicare & Medicaid Services (CMS) continues to recognize older E/M codes (99202–99215) for telehealth visits.
Key Medicare highlights for 2025:
- Home location billing (POS 10) remains valid through March 2025
- Audio-only visits require modifier 93
- Documentation must clearly mention the modality used (video or audio)
- For certain behavioral health services, home-based telehealth is permanently allowed
Providers should verify the Medicare Telehealth Services List regularly, as code acceptance varies by year and service type.
3. Originating Site and Location Rules
One of the biggest flexibilities of the pandemic era — allowing patients to receive telehealth services from home — has been extended through 2025.
However, there’s a possible “telehealth cliff” later this year. If Congress doesn’t renew the extensions, the traditional site restrictions (e.g., rural location or medical facility) could return.
Tip: Always document the patient’s physical location at the time of the visit to avoid claim denials.
4. Place of Service (POS) Codes and Modifiers
Billing accuracy depends on correct POS codes and modifiers.
| Code | Use Case |
|---|---|
| POS 10 | Patient at home during telehealth visit |
| POS 02 | Patient not at home but using telehealth |
| Modifier 93 | Audio-only telehealth |
| Modifier 95 | Synchronous telehealth using real-time audio/video |
Always confirm payer-specific requirements, as not all insurers follow Medicare’s POS and modifier structure.
5. Documentation & Compliance Tips
Accurate documentation is the foundation of compliant telehealth billing.
For every telehealth encounter, make sure to include:
✅ Patient consent for telehealth
✅ Type of technology used (audio/video)
✅ Patient’s physical location
✅ Provider’s location
✅ Duration and decision-making details
✅ Medical necessity and reason for virtual visit
Missing or incomplete documentation can lead to claim rejections or audits.
6. Remote Patient Monitoring and Related Services
Telehealth isn’t limited to live visits. In 2025, Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) are rapidly expanding.
- RPM codes (99453–99458) support continuous data collection (e.g., vitals, glucose, BP).
- RTM codes (98975–98978) track therapy adherence and patient engagement.
- These codes can be billed in addition to telehealth E/M services, increasing practice revenue.
7. Challenges to Watch in 2025
Even with these advancements, several challenges remain:
- Inconsistent payer adoption of new CPT codes
- Expiration of temporary flexibilities after March/Sept 2025
- Audio-only coverage limitations for non-mental health services
- Documentation errors leading to claim denials
Healthcare organizations must stay informed through payer updates, CMS bulletins, and ongoing RCM team training.
8. The Future of Telehealth Billing
Telehealth is no longer an emergency solution — it’s now a core part of patient care.
As AI, automation, and analytics merge with billing, expect smarter systems that auto-code, verify eligibility, and prevent denials in real time.
The key to success in 2025 and beyond?
👉 Stay current.
👉 Train your staff.
👉 Audit your claims regularly.
Conclusion
Telehealth Billing 2025 marks a major shift in how care is delivered and reimbursed.
From new CPT codes to evolving Medicare policies, every provider must adapt fast to ensure compliance and maximize revenue.
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