CPT Code for Telehealth Visit 2025–2026: The Complete Billing Guide

For synchronous audio-video telehealth: use standard E/M codes (99202–99215) with modifier 95 and POS 10 (patient at home) or POS 02 (patient at clinical site). For audio-only: 99441–99443. For remote patient monitoring: 99453, 99454, 99457, 99458.

Key Telehealth Billing Rules

Modifier 95 is required on all Medicare telehealth E/M claims. POS 10 (patient at home) reimburses at the non-facility rate. POS 02 for patient at a clinical site. Missing modifier 95 or wrong POS is the most common Medicare telehealth billing error.

Behavioral Health Telehealth Codes

90832 (16–37 min), 90834 (38–52 min), 90837 (53+ min) with modifier 95 and POS 10. Must credential with both commercial plans and MBHOs. See behavioral health credentialing.

Telehealth Credentialing Requirement

Providers must credential in every state where patients are located during telehealth visits. ProEnrollment manages multi-state telehealth credentialing across all 50 states. See our telehealth credentialing services.

The Core Telehealth Coding Framework

Telehealth E/M visits use standard office codes (99202–99215) with place-of-service and modifier signals: POS 02 (telehealth, patient not at home) or POS 10 (telehealth, patient at home), with modifier 95 where payers require it. Audio-only behavioral health visits remain billable under Medicare's permanent policy — append modifier 93 where required. Behavioral health adds the psychotherapy set (90832/90834/90837, 90791 intake) which all remain telehealth-eligible. Payer variation is real: some commercial plans still want modifier GT, others reject it; verify per contract.

Staying Paid: The Compliance Edges

Three edges where telehealth billing goes wrong: place-of-service mismatches (POS 10 vs 02 affects payment rates under Medicare), state licensure alignment (the rendering provider must be licensed where the patient sits — payers audit this), and enrollment gaps (billing a state's plan without enrollment in that state denies regardless of coding). Coding correctness can't rescue an enrollment problem — multi-state telehealth providers need the credentialing layer solid first. Multi-state telehealth credentialing | current telehealth rules | telepsychiatry credentialing.