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Tuesday Telehealth Tip: The New Telehealth Billing Landscape
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Hi Reader Last week I asked you to think about Chronic Care Management and Revenue Cycle Management. Many responses involved learning how added collections can help your practice and many of you are interested in learning how to get more of the revenue back that you have earned. Today we are starting a 3 week series on Billing and Reimbursement because denials are becoming more and more of an issue for Telehealth Providers. Let's face it, Payers are using AI to deny more often, and you need to adjust to get that money back. If your Telehealth billing hasn’t changed much since 2024, that’s a problem. The rules quietly shifted at the start of 2026, and a lot of practices are still running the old playbook — submitting claims the way they always have, and wondering why denials keep creeping up. The good news: the changes aren’t complicated once you know what to look for. The bad news: every claim you submit incorrectly is money you may not get back. Over the next three weeks we’re going to break it all down. Today: the big picture of what actually changed. First, the good news.Congress extended most Medicare Telehealth flexibilities through December 31, 2027. That means your patients can still be seen from home (not just rural areas), Telehealth visits are still reimbursable for many services, and the geographic restrictions that were supposed to snap back have been pushed out. For most practices, this is a genuine sigh of relief. Here’s where it gets tricky.In 2025, the AMA introduced a brand-new set of Telehealth E/M codes — 98000 through 98016 — specifically designed for virtual visits. Sounds great, right? Except CMS looked at them and said, “no thanks.” Medicare declined to adopt them, ruling they were duplicative of existing codes. The result? A split-track system where Medicare and most commercial payers now want completely different codes for the exact same visit. If your billing team isn’t tracking which payer gets which codes, you’re likely eating denials you don’t even know you’re generating. Two other changes that are catching providers off guard: • Modifier 93 is now required on all Medicare audio-only Telehealth claims. Forget it and the claim gets denied. (And no, Modifier GT is no longer required — using it on Medicare claims is actually a source of confusion right now.) • POS 02 vs. POS 10 matters — a lot. Whether a patient is receiving care at home (POS 10) versus at another Telehealth site (POS 02) determines your reimbursement rate. POS 10 (patient’s home) typically pays at the higher non-facility rate. Many practices are using these interchangeably and leaving money on the table. This Week's Challenge: Do you need help in this area? I have partnered with TSFC to help my clients get all the money owed to them! TSFC has proven to have a 98% first time approval rate and increase total revenue 20%. Even if you already have a company that helps, they can do a full audit for free of your Revenue and see if there are any gaps. All at no up front cost to you! Fill out the form below to see if you're a fit
Talk soon, -Dan P.S. Working with me 1-on-1 is $5,000. And Now It's 20% off! Use Promo Code "APRIL" This is the fastest way to get you where you want to go whether you are Launching a Telehealth Practice or wanting to Grow and Scale the one you currently have. Here's what we'll do:
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I'm a coach and entrepreneur who loves to talk about shaping the future of health & wellness by using the right technology. My mission is to make sense of health care tech and make it accessible to everyone. Subscribe and join over 4,000+ newsletter readers every week!
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