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Telehealth CPT Codes: Medicare and Payer Specific Telehealth

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Don’t follow the old pandemic trend anymore. In 2026, telehealth CPT codes have undergone an important transformation. It affects your medical billing, compliance and reimbursement across providers, practices and billing team. If you’re a healthcare provider, you need to know the updates, including new telehealth CPT codes.

This Guide breaks down everything you need to know, from new codes that change in 2025 to specialty-specific rules, with practical tips you can apply today.

What Are Telehealth CPT Codes?

Telehealth is a digital technology to allows healthcare providers to deliver care to patients remotely. Telehealth CPT codes 2025 are standardized numeric identifiers from the American Medical Association CPT code set that describe virtual healthcare services, like consulting via video, phone calls or brief virtual check-ins.

Why are they important:

  • Track services accurately
  • Comply with regulations
  • Secure reimbursement from Issuer (Medicare)
  • Improves claims and reduces denials

Before 2026, many telehealth services were billed using standard Evaluation & Management (E/M) codes, like CPT 99202 99215, along with modifiers 95 for interactive audio/video or 93 for audio-only, according to the Society for Maternal. Fetal Medicine.

New Telehealth CPT Codes For New Year

The American Medical Association (AMA) introduced 17 new telemedicine-specific codes and deleting the old telephone evaluation codes.

Key additions are given below:

  • Synchronous Audio-Video Codes
  • Synchronous Audio-Only Codes
  • Brief Communication

Code Range

Type

New or Est. Patients

Replaces

Purpose

98000-98007

Audio-Video

New and Established

Traditional E/M via telehealth

Real-time video visits

98008-98015

Audio-Only

New and Established

99441-99443

Medical discussion by phone

98016

Brief Communication

Both

G2012

Short patient check-ins

98016 is a new brief communication technology-based code that replaces the previous Medicare virtual check-in code G2012

Important:

These telehealth CPT codes are distinct from traditional E/M codes (99202-99215) and should not be reported together for the same encounter. The CPT telehealth codes update also clarifies that time-based billing requires explicit documentation of the total time spent on the date of service.

CPT Codes for Telehealth Visits

  • Telehealth visit coding uses CPT 98000-98015 for audio/video and audio-only services.
  • 98000-98007 apply to audio-video E/M visits for new and established patients.
  • Accurate coding requires documenting the technology used, time or MDM, and POS 02/10.
  • 98008-98015 are used for audio-only telehealth visits.
  • Some payers still allow 99202-99215 with telehealth modifiers like 95 (audio-video) or 93 (audio-only).
  • Medicare did not adopt CPT codes 98000-98015 for telehealth reimbursement.
  • Documentation must include patient location, reason for audio-only and technology used.

At HelloMDs, our medical coding services team reviews every encounter to ensure modifier and POS alignment, reducing rejections before claims leave your practice.

Audio-Only Telehealth CPT Codes

The American Academy of Family Physicians and CMS emphasize that Medicare allows audio-only technology only when the provider is technically capable of using audio-video, but the patient lacks the capability or doesn’t consent to video use. Your documentation needs to clearly state both conditions.

Audio-Only Billing Essentials:

  • Medicare: Use E/M codes 99202-99215 with modifier 93 with POS 10 (place of service) and document video availability.
  • Commercial payers: May accept 98008-98015 or standard E/M with modifier 93; check policy
  • Documentation: Include patient location, reason for audio-only, time or MDM, and technology used.

Billing Tip: Some payers may still require traditional E/M codes (e.g., 99213) with a telehealth modifier when they haven’t adopted the new CPT codes. Always verify payer policies for compliance.

Medicare and Payer-Specific Telehealth CPT Codes

Medicare Telehealth CPT Codes and Updates

  • Medicare telehealth CPT codes stick to traditional E/M like 99202-99215 with modifiers, not adopting new 98000-98015 codes.
  • Use POS 10 for home-based services and POS 02 for any Medicare telehealth serviceS.
  • Use 98016 for virtual check-ins (replaces G2012)
  • Use modifier 93 only for audio-only services
  • Use modifier 95, optional for audio-video services
  • CMS telehealth CPT codes extend flexibilities.

Aetna telehealth CPT Codes: A Commercial Payer

While we can’t cover every payer, let’s look at how Aetna telehealth CPT codes requirements might differ from Medicare:

Commercial payers like Aetna often:

  • Accept the new 98000-98007 audio-video codes.
  • May or may not accept 98008-98015 audio-only codes.
  • Have different modifier requirements (often 95 for audio-video).
  • Use various Place of Service designations.
  • Follow state-mandated parity laws affecting reimbursement rates.

Action step: Before each telehealth appointment, verify patient eligibility and benefits, ensuring telehealth coverage limits and any required authorizations are confirmed in advance. HelloMDs provides verification and denial management support to ensure accurate reimbursement regardless of payer policy.

Medicare Telehealth CPT Codes and Updates

Psychiatry and Specialty Telehealth Codes

Behavioral health leads telehealth adoption, and psychiatry telehealth CPT codes have specific rules:

These codes below are according to the Medicare Coverage Database (MCD)

  • 90791, 90792: Psychiatric diagnostic evaluation
  • 90832, 90834, 90837: Individual psychotherapy
  • 90846, 90847: Family psychotherapy sessions

Conclusion:

Telehealth CPT codes bring clarity and structure to virtual care billing, separating audio-video, audio-only, and brief communication services. Medicare continues using traditional E/M codes with specific modifiers, while commercial payers may adopt new AMA codes. Accurate documentation, including time, medical decision-making, patient location, and technology used, is essential to ensure compliance and avoid claim denials. Specialty-specific codes, like psychiatry, require additional attention. Understanding these updates helps practices streamline telehealth workflows, improve reimbursement, and stay audit-ready.

Disclaimer

This content is for general information only and is not official medical or billing advice. Always confirm codes and guidelines with Hello MDs’ professionals. Some examples may be illustrative.

Frequently Asked Questions

No. Commercial payers may adopt them at different times. Always check each insurer’s policy to determine which codes are accepted for reimbursement.

These older audio-only codes were deleted in 2025. AMA introduced 98008-98015 for audio-only visits, but Medicare still uses traditional E/M codes with modifier 93.

Yes, but document clearly for each service type. Use appropriate CPT codes, modifiers, and POS, ensuring compliance with payer rules for same-day billing.

Yes, psychiatry and behavioral health have specific CPT codes like 90791, 90834, 90837 for virtual evaluations and psychotherapy sessions, following payer and Medicare guidance.

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