Telehealth is here to stay and will keep growing, providing more opportunities for both healthcare providers and patients. As technology improves, remote care will become even easier, allowing for better management of conditions and communication. The flexibility of telehealth will only increase, making more services available online.
For practices, adapting to these changes now means being prepared for a future where telehealth is a regular part of healthcare delivery. In this blog, we will break down the basics of telehealth, highlight the key updates you need to know, and show you how to keep your practice compliant and efficient while continuing to provide excellent care.
What is Telehealth?
We will start with the basics. Telehealth, also known as telemedicine, refers to the use of electronic communication and information technology to deliver healthcare services remotely. This can include tools such as video calls, image sharing, streaming media, and both wired and wireless communications. The way telehealth services are billed can vary based on your location and the specific insurer or payer involved.
Telehealth offers healthcare providers several key benefits, such as:
- Enhancing continuity of care for patients
- Expanding access to medical services outside of traditional hours
- Reducing the need for travel for both patients and providers
- Addressing clinician shortages, particularly in rural and underserved regions
- Assisting in the management of chronic conditions for patients
- Facilitating COVID-19 symptom screening and making referrals when needed
- Allowing vulnerable individuals to receive care safely during the pandemic
- Contributing to the prevention of infectious disease spread
- And much more.
Types of Telehealth
- Live Video – Also known as “real-time” telehealth, this involves a two-way, face-to-face interaction between a patient and healthcare provider using audiovisual technology.
- Store-and-Forward – This method involves the remote evaluation of recorded images or video submitted by an established patient for later review by a healthcare provider.
- E-visits – These are patient-initiated, non-face-to-face communications that occur through a secure online portal, allowing patients to communicate with their provider.
- Remote Patient Monitoring – Digital technologies collect patient health data, such as vital signs, weight, blood pressure, blood sugar, or pacemaker readings, and securely transmit this information to healthcare providers in another location.
- Audio-only Visits – Healthcare visits conducted over the phone without the use of video, offering a convenient option for patients.
- Mobile Health (mHealth) – Patients use mobile devices like smartphones and tablets to access and track their health data, often via specialized apps, enabling communication about their health status and any changes, typically from home.
- Case-based Teleconferencing – A collaborative method that connects multiple healthcare providers, often across different disciplines, to offer coordinated and integrated care. It may involve family members or close supporters of the patient when appropriate.
When to Consider Telehealth
The decision to use telehealth is typically based on the patient’s needs and the specific circumstances, with the healthcare provider making the final call. Here are some scenarios where telehealth may be more or less suitable:
| Telehealth is likely appropriate for | Telehealth is less appropriate for |
| Mental health counseling | Health concerns that requires a procedure |
| Nutrition Counselling | Eye complaints |
| Dermatology | Abdominal pain |
| Prescriptions for medicine | Highly nuanced or multiple complex health concerns |
| Counseling about diagnostic and therapeutic options | Dental pain or urgent complaints |
| General wellness visits | Gynecologic complaints |
| Management of chronic conditions | Any situation in which a physical exam would change your recommendation |
| Discussion of test results |
Telehealth for Medicare Patients Gets a Boost Through March 2025
Congress has passed the Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025, extending telehealth services for Medicare patients until March 31, 2025. Originally, these services were only available until December 31, 2024. This extension helps healthcare providers continue offering telehealth, which became especially important during the COVID-19 pandemic.
Key updates include:
- Removal of Originating Site Restrictions: Patients can now access telehealth services from any location in the U.S., including their homes, until March 31, 2025.
- Expanded Telehealth Providers: The list of healthcare providers eligible to offer telehealth services, expanded during the COVID-19 pandemic, will remain in effect until March 31, 2025.
- RHC and FQHC Telehealth Services: Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can continue offering and receiving reimbursement for telehealth services until March 31, 2025.
- In-Person Requirement for Medicare Mental Health Services: The requirement for an in-person visit prior to an initial telehealth mental health consultation will be delayed until after April 1, 2025.
- Audio-Only Telehealth: Coverage and reimbursement for audio-only telehealth services will end on March 31, 2025.
- Hospice Care Recertification: Telehealth will continue to be allowed for the required face-to-face encounters before hospice care recertification until March 31, 2025.
Under the Consolidated Appropriations Act of 2023, numerous telehealth services and flexibilities were extended through December 31, 2025, and now have been further extended until December 31, 2026. These extensions guarantee ongoing access to essential telehealth services, impact various care settings, and offer greater flexibility in delivering services.
Below is a summary of each update, effective January 1, 2025, and available through the end of FY 2025. Some codes will remain on the CMS list on a “Provisional Basis for FY 2025.
Confused by Telehealth Billing Changes in 2025?
Talk to a Telehealth Billing SpecialistComprehensive Overview of Extended Telehealth Billing Services and Codes for 2025
| Service | CPT/HCPCS Codes | Overview | Effective Until |
| Office & Outpatient E/M Visits | CPT: 99202-99215 | Allows remote evaluation and management (E/M) office visits for continued access to routine healthcare services. | March 31, 2025 |
| Behavioral Health Services | CPT: 90791-90834, 96150-96159; HCPCS: G0511, G0512 | Covers mental health services like psychotherapy and behavioral assessments, expanding telehealth for mental care. | |
| Caregiver Training Services | CPT: 97550, 97551, 97552, 96202, 96203; HCPCS: G0541-G0543, G0539-G0540 | New codes for remote caregiver training, providing families and caregivers with skills to assist patients at home. | |
| Substance Use Disorder (SUD) Services | HCPCS: G2086, G2087, G2088, G2067-G2075 | Supports remote treatment of substance use disorders, such as counseling and medication management. | |
| Physical, Occupational, & Speech Therapy | CPT: 97110, 97112, 97116, 97530, 97535, 97150 | Provisional status for telehealth services in physical, occupational, and speech therapies, pending future decisions. | |
| Preventive Services | CPT: 99381-99397, G0438, G0439 | Provides telehealth access for preventive exams and wellness visits to promote proactive health management. | |
| Diabetes Self-Management Training (DSMT) | CPT: G0108, G0109 | Supports remote diabetes education, helping patients manage their condition from home. | |
| Nutrition Counseling | CPT: 97802-97804, G0270, G0271 | Covers telehealth diet and nutrition counseling for managing conditions like diabetes and obesity. | December 31, 2025 |
| Chronic Care Management (CCM) | CPT: 99490, 99487, 99489 | Enables remote management of chronic conditions, ensuring comprehensive care coordination for patients. | |
| Cardiac & Pulmonary Rehabilitation | CPT: 93797, 93798, G0422, G0423, G0424 | Supports remote cardiac and pulmonary rehabilitation for heart and lung condition patients. | December 31, 2025 |
| Emergency Department Visits | CPT: 99281-99285 | Allows telehealth for emergency department visits when in-person care is not immediately available. | December 31, 2025 |
| Home Health Services | CPT: G2061-G2063, G2250, G2251 | Extends telehealth check-ins and services for homebound patients. |
Summary of Updates
| Update | Detail |
| New CPT Codes (98008-98015) | Introduces codes for audio-only telehealth E/M services for new (98008-98011) and established patients (98012-98015). |
| CMS Stance on Audio-Only Codes | CMS encourages use of G-codes for Medicare reimbursement, with telehealth visits reported using in-person E/M codes. |
| Geographic Restrictions | Extended until March 31, 2025, with exceptions for certain services like behavioral health and ESRD-related assessments. |
| Office Visit Codes (99212-99205) for Telehealth | CMS clarifies that telehealth services provided in the patient’s home (POS 10) will continue at the non-facility rate starting in CY 2025. |
New and Deleted Telemedicine Billing Codes for CY 2025
The 2025 CPT manual introduces 17 new codes for telemedicine visits, including both audio-visual and audio-only services for new and established patients. These new codes (98008–98015) are designed to align with updates to medical decision making (MDM) and time-based thresholds from the revised evaluation and management (E/M) guidelines, helping to determine the appropriate coding based on time and complexity of the visit.
However, the Centers for Medicare & Medicaid Services (CMS) has decided not to adopt these new codes for telehealth services, citing limitations in statutory requirements. CMS will continue to use the current E/M codes for audio-visual and audio-only telemedicine visits instead.
Providers should be aware that telehealth policies differ across commercial, self-funded, and Medicare Advantage (MA) plans. It is crucial for providers and their teams to verify the latest telehealth policy updates with individual insurance plans. Likewise, since Medicaid policies are state-specific, checking with the local Medicaid agency or Medicaid Managed Care Organizations (MCOs) is recommended for the most accurate and up-to-date information.
Key Updates to Telehealth Coding:
- Starting January 1, CPT codes 99441–99443 will no longer be valid for telemedicine visits.
- Modifiers 93 and 95, which indicated the use of audio-only or audio-visual technologies, are no longer necessary (except for Medicare claims). The new codes will now specify the mode of service delivery, eliminating the need for these modifiers.
New Codes for Synchronous Audio-Video Telemedicine:
For new patients:
- 98000: Straightforward medical decision-making (MDM) or 15-29 minutes.
- 98001: Low MDM or 30-44 minutes.
- 98002: Moderate MDM or 45-59 minutes.
- 98003: High MDM or 60-74 minutes.
- For visits lasting over 75 minutes, use prolonged services code 99417 (non-Medicare) or G2212 (Medicare).
For established patients:
- 98004: Straightforward MDM or 10-19 minutes.
- 98005: Low MDM or 20-29 minutes.
- 98006: Moderate MDM or 30-39 minutes.
- 98007: High MDM or 40-54 minutes.
- For visits lasting over 55 minutes, use prolonged services code 99417 (non-Medicare) or G2212 (Medicare).
New Codes for Synchronous Audio-Only Telemedicine:
For new patients:
- 98008: Straightforward MDM or 15-29 minutes.
- 98009: Low MDM or 30-44 minutes.
- 98010: Moderate MDM or 45-59 minutes.
- 98011: High MDM or 60-74 minutes.
- For visits lasting over 75 minutes, use prolonged services code 99417 (non-Medicare) or G2212 (Medicare).
For established patients:
- 98012: Straightforward MDM or 10-19 minutes.
- 98013: Low MDM or 20-29 minutes.
- 98014: Moderate MDM or 30-39 minutes.
- 98015: High MDM or 40-54 minutes.
- For visits lasting over 55 minutes, use prolonged services code 99417 (non-Medicare) or G2212 (Medicare).
Asynchronous Communication Services:
For services delivered asynchronously, the codes 98000–98015 should not be used. Instead, providers should report CPT code 98016, which covers brief communication technology-based services, typically virtual check-ins.
This code is used for established patients who request a review to determine whether a more intensive E/M service is needed. Note that CPT code 98016 cannot be used if the issue arose from a related E/M service within the previous seven days or if the patient requires an urgent visit within 24 hours or the next available appointment.
The Bottom Line
Telehealth is here to stay, and it’s transforming healthcare delivery. However, providers must stay on top of CMS guidelines, telehealth coding, and reimbursement updates to ensure compliance and proper billing. With new codes and ongoing extensions of services through 2025, now is the time to familiarize yourself with the latest updates and adjust your telehealth practices accordingly.
