Urgent Telehealth Code Changes Announced

TELEHEALTH 2025 CODE CHANGES

Well, leave it to Medicare to completely throw a wrench in everything and just now update everyone with how they expect telehealth to be billed moving forward as of January 1st, 2025. Please click here to see the attached notice. Medicare is not recognizing the new telehealth code set. Based on this notice we are suggesting providers bill as the below.

If you use our RCM service, our team will be working in the background to make these corrections as well for any new and previous claims that have been billed. 

Bill Medicare and Medicare Advantage as:

E/M Visit (99201-99205 or 99212-99215) audio only with a modifier 93

E/M Visit (99201-99205 or 99212-99215) audio/visual with a modifier 95

Bill Commercial and Medicaid as:

New CPT codes for 2025:

98000-98015 depending on new and established status, times/MDM and if it is audio only or audio/visual.

We have also received details that Medicare will only recognize telehealth until 03/31/2025. The commercial plans we have not seen any deadlines yet for them and will continue to watch for updates on this. 

We are all learning together and it is a day-to-day process. We are here to help answer any questions and will continue to provide correct updates when they are received.

As always, reach out if any questions.