How Telehealth CPT Codes Are Evolving in 2025?

Telehealth CPT codes are evolving rapidly in 2025 to support expanded remote care while addressing payer compliance. CMS and commercial payers are retaining expanded telehealth coverage for key CPT codes in 2025, but with updated guidelines, requiring providers to align with place of service, modifier use, and documentation changes. This evolution ensures telehealth remains accessible while maintaining billing accuracy and audit readiness for healthcare practices.

• 99421-99423 (Online E/M) remain payable under certain time-based criteria.
• 99202-99215 can still be billed for telehealth if real-time audio-video is used.
• Newer RPM codes (99453, 99454, 99457, 99458) continue to be billable, but payers increasingly require documented patient consent and device data.
• Behavioral health codes like 90833, 90834, 90837 remain telehealth eligible.

However, payers like Aetna, UHC, and Medicare Advantage plans are increasing pre-payment audits for time documentation and patient location requirements. At Preferred MB, our expert ensures your practice uses current payer telehealth codes to bill these evolving codes accurately.

How to Avoid Denials on Telehealth Claims in 2025?

To avoid denials on telehealth claims in 2025, as an healthcare provider you must stay updated with payer-specific billing and documentation requirements. Denials for telehealth claims often occur due to missing modifiers, incorrect place of service codes, and insufficient documentation of patient consent or service details. By implementing thorough claim reviews and staff training, your practice can protect revenue while ensuring compliance with evolving telehealth guidelines.

• Missing place of service (POS 02 for telehealth, POS 10 for patient home).
• Lack of appropriate modifiers (modifier 95, GT where required).
• Insufficient documentation of patient consent or service time.

How Preferred MB Handles Modifiers and POS Codes for Telehealth Correctly?

Preferred MB, billing team handles telehealth billing with precision by verifying each payer’s evolving requirements before claims submission. POS and modifiers for telehealth vary by payer, so Preferred MB billing specialists carefully assigns correct codes to align with payer-specific guidelines while ensuring documentation accuracy. Our this approach help your practice avoid delays and denials while capturing full reimbursement for telehealth services in 2025.

• Medicare: POS 02 or 10 with modifier 95.
• Some Medicaid plans require POS 02 only.
• Certain commercial payers require modifier GT instead of 95.

Preferred MB’s billing workflows automate correct modifier placement and POS usage for each payer, reducing rejections and speeding reimbursements for your telehealth visits.

How Accurate Time Documentation Impacts Telehealth Reimbursement?

Accurate time documentation is more important for securing full telehealth reimbursement and withstanding audits in 2025. For CPT codes like 99421-99423 or 99213/99214 via telehealth, time-based documentation is required to justify the level of service billed and to align with payer policies. Without precise start/stop times and clear documentation of counseling or care coordination, practices risk underpayment or denials on telehealth claims.

• Document patient identity verification.
• Note start and stop times.
• Record patient consent for telehealth.
• Ensure medical decision-making level aligns with the code billed.

Preferred MB provides checklist templates for your providers, ensuring documentation compliance and preventing revenue loss during audits.

How Preferred MB Helps Practices Navigate State-Specific Telehealth Policies?

Preferred MB helps practices navigate complex state-specific telehealth rules by providing clear, updated billing guidance tailored to each state’s laws. State parity laws and telehealth billing policies vary across the USA, requiring careful alignment with documentation, covered services, and payer rules to avoid denials. With Preferred MB’s support, practices can confidently expand telehealth services while ensuring compliance and maximizing reimbursement.

• California requires payment parity for telehealth.
• Texas Medicaid has specific telehealth and telemonitoring rules.
• Florida’s commercial payers have unique modifier requirements.

Preferred MB’s credentialed billing specialists track each state’s telehealth policies to ensure your claims align with updated 2025 regulations, reducing compliance risk and delays.

How Remote Patient Monitoring (RPM) and Telehealth Intersect in 2025?

In 2025, Remote Patient Monitoring (RPM) and telehealth are increasingly integrated to enhance chronic care while expanding virtual service lines for practices like your in the USA. RPM codes (99453, 99454, 99457, 99458) are often misunderstood, leading to missed opportunities or denials if not paired correctly with telehealth visits and documentation requirements. Our certified billing experts align RPM with telehealth strategies, your practice can improve patient outcomes while capturing additional, compliant revenue streams.

• They do not count as telehealth but are often part of virtual care strategies.
• Must involve device data transmission and 20+ minutes of management for 99457.
• Documentation of device data, patient engagement, and care plan is required.

Preferred MB ensures clean separation between RPM and synchronous telehealth claims, reducing audit triggers.

How to Increase Your Telehealth Revenue with Accurate Coding?

Accurate telehealth coding is key to boosting practice revenue while avoiding unnecessary payment delays in 2025. Our team ensure accuracy in telehealth CPT coding to increase your revenue by 18-24% by reducing denials. Our strategies include consistent use of correct modifiers, precise time and service documentation, and payer-specific telehealth policy checks before claim submission.

• Using the correct level of service codes based on MDM or time.
• Applying correct modifiers and POS.
• Billing for services like CCM (99490) and RPM alongside telehealth when eligible.

Preferred MB manages these details for your practice so your providers can focus on care while maximizing revenue.

How Preferred MB’s Telehealth Medical Billing Services Support Your Practice?

Preferred MB’s telehealth medical billing services help your practice capture full reimbursement while reducing billing stress. Preferred MB offers end-to-end telehealth billing services including payer policy checks, accurate coding, clean claim submission, and denial management. This comprehensive support allows your team to focus on patient care while confidently expanding your telehealth services in 2025.

• Credentialing with payers for telehealth approval.
• Verification of payer telehealth policies by state and plan.
• Accurate charge entry with correct CPT, POS, and modifiers.
• Aggressive AR follow-up and denial management for telehealth claims.
• Monthly reports showing telehealth collections, denial reasons, and areas for optimization.

With telehealth continuing to account for up to 28% of outpatient visits in the USA in 2025, ensuring your billing is accurate and compliant is essential to your practice’s sustainability.

Final Thoughts: Secure Your Telehealth Revenue in 2025 with Preferred MB

Telehealth is no longer an optional service; it’s a core part of patient care. However, improper telehealth billing can drain your revenue and increase audit risks. By partnering with Preferred MB, your practice gains:

• A dedicated team of telehealth billing experts.
• Up-to-date knowledge of evolving CPT and payer policies.
• Faster payments and fewer denials