Coding for telehealth: Audio, video and virtual-digital visits
Ensure accurate billing and payment with telehealth codes for Medicare, Medicaid and private payers.
Note: The information provided below is not intended to be advisory. The AAFP recommends that physicians verify each payer's policy and ask patients to verify their coverage ahead of appointments.
Coding for audio-video visits
Medicare
Medicare will continue to cover telehealth for beneficiaries, regardless of their location, through December 2027.
Medicare did not adopt the new audio-video CPT codes (98000-98007). Instead use the appropriate office visit evaluation and management CPT code as outlined below:
| CPT Codes | 99202-99205 99211-99215 |
| Place of Service (POS) |
Use the POS that aligns with the patient's location. POS 02: Telehealth Provided Other than in a Patient's Home POS 10: Telehealth Provided in a Patient's Home (a location other than a hospital or other facility where the patient receives care in a private residence)* |
As of January 1, 2024, Medicare pays for telehealth services provided in the patient’s home (POS 10) at the non-facility rate. Telehealth services provided at an originating site (POS 02) are paid at the facility rate. You can look up the non-facility and facility rates using the Medicare physician fee schedule lookup tool.
Medicare does not require a modifier for audio-video telehealth services.
Private payers
Commercial, self-funded, and Medicare Advantage polices regarding telehealth vary, including their adoption of the new audio-video CPT codes (98000-98007). Check with your local provider relations representative for their most recent policies.
Medicaid
Similarly, Medicaid policies are established at the state level, including their adoption of the new audio-video CPT codes (98000-98007). Check with your local Medicaid agency and/or Medicaid Managed Care Organizations (MCOs) for their policies.
Coding for audio-only visits
Medicare
Medicare's telehealth coverage through December 2027 includes audio-only services.
Medicare will allow use of audio-only communication technology for any telehealth service provided to a patient in their home if the physician is capable of using an audio-video telecommunications system, but the patient is unable or does not consent to use of video. A list of Medicare’s telehealth services is available here.
Use the CPT or HCPCS code that best describes the service provided (e.g., 99202-99215).
Beginning January 1, 2025, CPT Codes: 99441-99443 are no longer available. Medicare did not adopt the new audio-only CPT codes (98008-98015).
Append CPT modifier 93 to services provided via audio-only.
Federally qualified health centers and rural health centers should use modifier FQ, 93, or both where appropriate and true as they are identical in meaning.
Documentation must reflect that the physician has audio-video available, but the patient preferred audio-only or wasn’t able to use audio-video.
Private payers
Commercial, self-funded and Medicare Advantage polices regarding telehealth vary, including their coverage of audio-only and whether they adopted the new audio-only CPT codes (98008-98015). Check with your local provider relations representative for their most recent policies.
Medicaid
Similarly, Medicaid policies are established at the state level, including their coverage of audio-only and whether they adopted the new audio-only CPT codes (98008-98015). Check with your local Medicaid agency and/or Medicaid Managed Care Organizations (MCOs) for their policies.
Video tips: Optimize your telehealth program
Coding for virtual-digital visits
E-visits are non-face-to-face, patient-initiated communications with the physician through an online patient portal. The communications can occur over a seven-day period, and the exchange must be stored permanently.
Virtual check-ins are brief conversations with a physician or other clinician to determine if an in-person visit is necessary. The communication cannot be related to a medical visit within the previous seven days and cannot lead to medical visit within the next 24 hours (or soonest appointment available).
Medicare
E-visits and virtual check-ins are considered communication technology-based services (CTBS). They aren't impacted by expiration of telehealth waivers. Practices may continue to provide CTBS to all patients regardless of where the patient is located.
eVisit
| 99421 | Online digital E/M service, for an established patient, for up to seven days, cumulative during the seven days, 5-10 minutes |
| 99422 | Online digital E/M service, for an established patient, for up to seven days, cumulative during the seven days, 11-20 minutes |
| 99423 | Online digital E/M service, for an established patient, for up to seven days, cumulative during the seven days, 21 or more minutes |
E-visits should not be billed on the same day the physician reports an office visit E/M service (CPT codes 99202-99205 and 99211-99215) for the same patient. Additionally, e-visits should not be billed when using the following codes for the same communication:
99091
99339-99340
99374-99380
99487 and 99489
99495-99496
Virtual check-in
| G2010 | Remote evaluation of recorded video or images submitted by an established patient (e.g., store and forward), including interpretation and follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment |
| 98016 | Brief communication technology-based service (CTBS), e.g. virtual check-in, by a physician or other QHP who can report E/M services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
| G2252 | Brief CTBS, e.g., virtual check-in, by a physician or other QHP who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion |
Medicare replaced G2012 with CPT code 98016.
Private payers
Commercial, self-funded and Medicare Advantage polices regarding telehealth vary. Check with your local provider relations representative for their most recent policies.
Medicaid
Similarly, Medicaid policies are established at the state level. Check with your local Medicaid agency and/or Medicaid Managed Care Organizations (MCOs) for their policies.
Virtual/digital scenario notes
Patient consent is required and may be obtained either before or at the time of service.
Virtual check-ins and e-visits must be initiated by a patient. Physicians and other providers may first need to educate beneficiaries on the availability of the service.
There are no POS or modifier requirements for virtual check-ins or e-visits. Use the POS used for typical services.