Telemedicine wasn’t a popular and widely accepted model till 2019. However, the spread of the deadly pandemic at the end of 2019 has put it in the limelight. The lockdown and confinement of masses at their homes made Telemedicine a go-to option for patients worldwide. It enhanced its role tremendously in the healthcare sector.
Rise of Telemedicine
Currently, Telemedicine benefits both patients and healthcare providers not only in emergencies but also in non-emergency cases. In 2025 and onwards, it is going to be the most preferred model in healthcare. Only in the US, around 20% of large healthcare facilities have started facilitating Telemedicine and remote patient monitoring. According to Tateeda, 88% of the patients received some form of remote healthcare in 2024.
We’ve seen a staggering increase of 1300% in Telemedicine and RPM claims between January 2019 and November 2022. So, the numbers will only ascend in the times to come and Telemedicine is the future.
What is Telemedicine?
According to the Federal Communications Commission, “Telemedicine can be defined as using telecommunications technologies to support the delivery of all kinds of medical, diagnostic and treatment-related services usually by doctors. For example, this includes conducting diagnostic tests, closely monitoring a patient’s progress after treatment or therapy, and facilitating access to specialists that are not located in the same place as the patient.”
Telemedicine provides patients with fast, virtual access to their healthcare provider. People suffering from any disease aren’t required to visit a hospital, facility, or clinic in person. They can conveniently discuss their health issues with a doctor or physician over video/audio calls or secure text messaging software. Simply put, this is an alternate, advanced, and innovative method of providing medical care to those in need.
Benefits of Telemedicine
Also known as digital health, Telemedicine is the combination of telecommunication technology and medical care to provide better virtual care. The integration of technology in the healthcare sector has always benefited providers and those who require care.
Some benefits of Telemedicine for patients are easy access to quality care, no chair times, and flexibility. For providers, they don’t have to deal with crowded waiting rooms and always occupied offices; they can provide care even to patients who cannot visit their office in person.
Here are some key benefits of Telemedicine.
Convenience
You can talk to your doctor, share your issues, and get diagnosed or treated from the comfort of your house or office. Have a one-on-one meeting with your healthcare provider from your bedroom or lounge.
No Traveling
No need to plan and travel for your appointment. Now, you can access your doctor easily without setting foot outside your house. It also saves patients from the hectic traffic and expensive fuel consumption.
Quick Access to Quality Care
Doctors across the US reserve a portion of their office time for telemedicine consultations. So, instead of a physical visit to their office, scheduling a video or audio appointment means faster care delivery with no hassles.
No More Chair Time
No need to visit the doctor’s office early and wait for your turn. It saves the patient’s precious time, and likewise, the doctors can treat more patients in a day as compared to one-on-one consultations.
More Secure
Telecommunication technology integrated into the health sector is secure and helps to protect patient privacy. Apart from security, this mode of healthcare ensures patients get the undivided attention of their doctor.
Safety from Germs and Viruses
Not visiting the hospital or large facilities means you and your loved ones are safe from germs and viruses. No more spreading of contagious diseases and carrying germs from the healthcare facility to your home.
More choices
Telehealth means more choices at hand. Gain satisfactory care from thousands of skilled doctors and physicians spread all over the country. This way, you have peace of mind that you’re getting the right treatment.
Quality Care in Remote Locations
Telemedicine or remote patient monitoring has erased the disparities between urban and rural populations. Providers can now provide compassionate care to those living in far-off areas and cannot afford to visit the facility.
Changes and Revisions in CPT 2025 Coding for Telemedicine
The new CPT code release for the year 2025 sees 420 updates with the addition of 270 codes, 112 deletions, and 38 revisions. This code set will be effective from the 1st of January 2025.
Addition of Telemedicine Codes to Evaluation and Management (E/M)
The American Medical Association (AMA) has included telemedicine services in the Evaluation and Management section of CPT. The category sees 17 codes divided to report the exact type of technology used and type of patient.
For instance, different codes for audio/video services and new or established patients. The CPT change also includes codes for audio-only services. The codes discussed below are used to document synchronous, real-time interactive encounters between the patient and the healthcare specialists.
CPT Code Technology Used Patient Type Medical Decision Making (MDM) Minimum Time
CPT Code | Technology Used | Patient Type | Medical Decision Making (MDM) | Minimum Time |
98000 | Audio-Video | New | Straightforward | 15 mins |
98001 | Audio-video | New | Low | 30 mins |
98002 | Audio-video | New | Moderate | 45 mins |
98003 | Audio-video | New | High | 60 mins |
98004 | Audio-video | Established | Straightforward | 10 mins |
98005 | Audio-video | Established | Low | 20 mins |
98006 | Audio-video | Established | Moderate | 30 mins |
98007 | Audio-video | Established | High | 40 mins |
98008 | Audio-only | New | Straightforward plus more than 10 minutes of medical discussion | 15 mins |
98009 | Audio-only | New | Low plus more than 10 minutes of medical discussion | 30 mins |
98010 | Audio-only | New | Moderate plus more than 10 minutes of medical discussion | 45 mins |
98011 | Audio-only | New | High plus more than 10 minutes of medical discussion | 60 mins |
98012 | Audio-only | Established | Straightforward plus more than 10 minutes of medical discussion | 10 mins |
98013 | Audio-only | Established | Low plus more than 10 minutes of medical discussion | 20 mins |
98014 | Audio-only | Established | Moderate plus more than 10 minutes of medical discussion | 30 mins |
98015 | Audio-only | Established | High plus more than 10 minutes of medical discussion | 40 mins |
Place of Service (POS) Codes and Modifiers
If you’re a doctor/physician facilitating patients with Telemedicine or someone related to the billing field, you may be aware that billing and documentation for telemedicine visits is complicated. It involves multiple POS codes and modifiers like 93, 95, and GT.
Most insurance companies mandate a different set of these codes. So, including CPT codes will not make things easy. Also, CMS has clarified that these codes will not be covered based on the medical classification in the Social Security Act.
In 2025, it is important to determine which insurance companies require office or other outpatient visit codes like 99202 to 99215 and which ones require telemedicine consultation codes. While documenting and creating claims, it is important to consider state laws too. To maintain consistency, many states in the US mandate the same reimbursements for Telemedicine as for in-office visits.
Although the Centers for Medicare and Medicaid don’t cover these codes, they did set prices for these conditions and codes. So, the good news for patients opting for telemedicine services in 2025 is that these services can now be availed at even lower prices.
Telemedicine Code | 2025 Allowable | Office Visit Code | 2025 Allowable |
98000 | 49.81 | 99202 | 69.87 |
98001 | 82.16 | 99203 | 109.01 |
98002 | 131.00 | 99204 | 163.35 |
98003 | 173.70 | 99205 | 215.75 |
98004 | 38.49 | 99212 | 54.99 |
98005 | 67.28 | 99213 | 88.95 |
98006 | 99.30 | 99214 | 125.18 |
It is important to note that clinics may have to reshuffle pricing to ensure the payments align with the patients’ contract and specific state regulations. Also, audio-only codes (98008-98015) have taken over the codes representing telephonic conversations (99441-99443). To submit a claim for a telephonic call, the doctor or physician must spend at least 10 minutes with the patient.
Here again, it is important to mention that CMS will not cover these codes, but the information provided includes payment for telephone-only consultations. The reimbursement starts from $47.23 and goes up to $130.68.
Additional CPT Codes for Augmented/Artificial Intelligence (AI)
The inclusion of Augmented/Artificial Intelligence (AI) in Telemedicine resulted in the addition of 7 new codes. Included in the AI taxonomy category III of CPT codes, they help to add specificity by describing the services as assistive and autonomous. Below mentioned are some of these codes.
0877T: According to AAPC, CPT code 0877T, as maintained by the American Medical Association (AMA), is a code for Augmentative analysis of chest computed tomography (CT) data for interstitial lung disease (ILD).’
0898T: ‘A medical procedural code under the range – noninvasive prostate cancer estimation mapping with biopsy procedures.’
0902T: Wolters Kluwer describes 0902T as a ‘QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device.’
Common Telemedicine Billing Mistakes
The popularity of Telemedicine in the current times has benefitted both the patients and the providers. However, the inclination towards virtual health checkups means regulatory changes and expansion in telemedicine coverage to ensure proper reimbursements for providers.
However, there are a few complexities involved that lead to errors in claim creation and, hence, denials. Doctors and medical billing companies across the US are under immense pressure to keep up with the regulations. Still, the percentage of errors and claim denials keeps on rising. Here are some common billing mistakes in Telemedicine.
Not Knowing Correct Codes
CMS regulations keep fluctuating based on public healthcare requirements. This results in changing billing codes that practices are already using or acquainted with. So, once a change is made and you end up adding the wrong/outdated code in the claim will lead to delayed pending on even a denied claim.
How to avoid this mistake? Stay current with the latest changes, i.e., additions, revisions, and deletions of codes through trusted sources like AAPC, AMA, and CMS.
Wrong Record-Keeping or Documentation
As someone responsible for documenting and creating claims, it is imperative that you maintain correct documentation. It helps your practice to claim the correct amount right on time. Stay in touch with your administrative team and talk about the appropriate information required to maintain accurate records through documentation.
How to avoid this mistake? Create a checklist of the things you should mention in the documentation, including all the steps that start before the telemedicine consultation process. Remember to tick all the boxes once the process is over and you’re reimbursed.
No Proper Training for Telemedicine Billing Staff
Yes, telemedicine coding and billing are complicated. Your team is under immense pressure to add appropriate codes where required. They should be aware of hundreds of CPT codes. The CPT code updates for Telemedicine 2025 have made things more complex for your staff.
How to avoid this mistake? Regular training is the only solution to this problem. Arrange training on CPT codes and Telemedicine coding for your team. Educate them on codes, HCPCS codes, modifiers, POS codes, and all processes involved to get complete reimbursements.
Verifying Patient Eligibility
Although most insurance companies operating across the US cover telemedicine, it is still wise to do eligibility verification before the virtual consultation. Eligibility verification services allow you to confirm if the payor covers the service required by the patient or not. You only have to verify patient eligibility only once for that particular policy.
How to avoid this mistake? Be proactive and check whether their policy covers telemedicine service before the patient’s first virtual consultation.
Telemedicine Coding is Difficult
We all know that telemedicine coding and documentation can be complicated. However, the scope of telemedicine and remote patient monitoring is bright and continues to expand. Patients find it convenient as it allows them to experience quality care from the comfort of their homes without the hassle of traveling and waiting in the queue for their turn.
With telemedicine growing exponentially, the 2025 CPT code update promises to streamline billing processes and, hence, elevate patient care. The inclusion of new codes and changes reflect the evolution of the virtual care model. The changes ensure quality care, optimized reimbursements, and enable providers to fulfill regulatory compliance.
As a healthcare specialist or someone related to the medical or billing industry, it is important to stay updated with the changes to counter the complexities of coding. With standard bodies working hard to simplify the healthcare provision process and the intricacies involved, keeping up with the new releases can be tough.
Let I-Med Claims Simplify The Telemedicine Billing For You
Stress no more! I-Med Claims is here to help you with telemedicine billing. We promise to simplify your billing processes and ensure accurate payments against our high correct claim submission. Our telemedicine billing team is well-versed with telemedicine coding, the POS codes and HCPCS modifiers.
We ensure strict compliance and error-less billing by providing continuous training to our billing staff. We analyze your RCM needs and start with a comprehensive audit to ensure that you’re in line with the state and federal regulations.
Lastly, our meticulous optimization process ensures an error-free revenue cycle where all pieces fall in the right place. You get timely and complete payments against your services and that no bill is delayed or denied due to a compliance or coding error.