Telehealth visits are billed differently from in-person visits in several specific ways, and getting these details wrong is a common source of denials for practices that added virtual care without adjusting their billing workflow to match.
The two elements that matter most are the place-of-service code and the modifier. Depending on the payer, a telehealth visit might require place-of-service code 02 (telehealth, patient not in their home) or 10 (telehealth, patient in their home), plus a modifier such as 95 or GT indicating the service was delivered via real-time audio-video technology. Using the wrong combination — or omitting the modifier entirely — is one of the most frequent telehealth-specific denial causes.
Payer rules for telehealth also vary more than for in-person care, particularly around which CPT codes are eligible for telehealth delivery at all, and whether audio-only visits (without video) are reimbursed the same as audio-video ones. Because these rules have shifted repeatedly across payers in recent years, practices offering telehealth benefit from maintaining a simple, regularly updated reference of which codes and modifiers each major payer currently accepts, rather than assuming last year’s rules still apply.