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Accurate telehealth billing is essential for clean claims and timely payments in 2026. While no single rule fits every payer, there are clear, proven guidelines to navigate location codes and modifiers correctly. Here’s how you can bill telehealth with confidence and avoid costly denials.
Use the Correct Place of Service (POS) Code
POS codes tell payers where the patient was during the visit—this directly impacts your reimbursement rate.
What to include:
These steps ensure claims reflect reality and meet payer requirements for telehealth payment.
Apply Modifier 95 Appropriately
Modifier 95 confirms your visit used real-time audio and video—not just a phone call. It’s required by Medicare and most commercial insurers.
Tips:
Stay Physically Active
Moderate exercise improves circulation and supports the movement of immune cells. 30 minutes of walking, cycling, or stretching daily can strengthen your body’s response to illness. Avoid excessive high-intensity training, which may temporarily suppress immunity.
Verify Patient Location Before Every Visit
Knowing where your patient is located during a telehealth session determines whether to use POS 10 or POS 02. Guessing can trigger audits or underpayment.
Accurate location coding protects your revenue and ensures compliance.
While you can’t control every payer rule, consistent attention to POS codes, modifiers, and documentation gives your claims the best chance of success. Small, consistent habits—verifying location, using Modifier 95 correctly, and staying payer-informed—go a long way in securing your practice’s revenue.
Prevention is better than correction. Start with your telehealth billing checklist—your bottom line will thank you.
Elemmentor Box
Dr. Jenifer Olivia
Cardiologist, Maxcare Hospital
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