Telehealth Billing in 2025: Challenges & Solutions

Telehealth has transformed the healthcare industry, offering convenient, remote patient care while increasing access to medical services. However, billing for telehealth services in 2025 comes with significant challenges, including evolving regulations, claim denials, and complex reimbursement policies.

For healthcare providers in the U.S., understanding the latest telehealth billing guidelines is crucial to maximizing insurance reimbursements and revenue cycle efficiency. In this blog, we’ll discuss the top telehealth billing challenges and effective solutions to ensure you get paid for the services you provide.

Understanding the Current Landscape of Telehealth Billing in 2025

The demand for virtual healthcare services continues to grow, with more patients and providers relying on telemedicine consultations, remote monitoring, and digital health platforms. As a result, Medicare, Medicaid, and private insurers have updated their telehealth billing policies to accommodate new healthcare delivery models.

Despite these advancements, healthcare practices still face hurdles in telehealth reimbursement, leading to denied claims, revenue loss, and administrative burdens.

Top Telehealth Billing Challenges in 2025

1. Complex Reimbursement Policies Across Payers

Each insurance provider, including Medicare, Medicaid, and private payers, has different telehealth reimbursement rules, CPT codes, and coverage criteria. Some telehealth services may not be covered or may require prior authorization, leading to payment delays.

Solution:

• Stay up-to-date with payer-specific telehealth policies and reimbursement guidelines.
• Work with an expert medical billing company to ensure accurate coding and claim submission.

2. Increased Claim Denials and Rejections

Telehealth claims often get denied due to incorrect modifiers, place of service (POS) codes, or insufficient documentation.

Solution:

• Use the correct CPT, HCPCS, and ICD-10 codes for telehealth visits.
• Ensure proper documentation to justify medical necessity.
• Partner with a telehealth billing specialist to prevent errors and resubmit denied claims efficiently.

3. Medicare and Medicaid Policy Changes

Medicare and Medicaid have expanded telehealth coverage in recent years, but temporary pandemic-era policies are constantly changing. Some services may be phased out or revised, impacting provider reimbursements.

Solution:

• Regularly check CMS updates and Medicaid state-specific guidelines for telehealth billing changes.
• Implement automated billing systems to track reimbursement updates.

4. Credentialing and Licensing Issues

Providers must be credentialed and licensed in the state where the patient is receiving care. Many payers deny claims if the provider is not appropriately licensed for interstate telehealth.

Solution:

• Verify state-specific licensing and payer credentialing requirements before offering telehealth services.
• Work with a billing service that handles credentialing to avoid compliance issues.

5. Incorrect Use of Telehealth Modifiers

Using the wrong modifier can lead to claim rejections and underpayments. Some commonly used telehealth modifiers include:

• Modifier 95 – Used for synchronous telehealth services
• Modifier GT – Indicating interactive telecommunication services
• POS 02 or POS 10 – Differentiating telehealth from in-person visits

Solution:

• Ensure correct modifier usage based on the payer’s billing policies.
• Implement billing software that automatically applies correct codes and modifiers.

How to Maximize Telehealth Reimbursements in 2025Telehealth continues to reshape healthcare by improving access to care, reducing patient wait times, and enhancing convenience for both providers and patients. However, maximizing reimbursements for telehealth services requires a strategic approach to billing, coding, and compliance.

To ensure faster payments, fewer denials, and optimized revenue cycle management, healthcare providers must stay updated on payer policies, telehealth billing codes, and evolving state and federal regulations. Below, we explore essential best practices for maximizing telehealth reimbursements and how Bridge Billing Services can help streamline your billing processes.

1. Verify Patient Eligibility Before Every Telehealth Visit

One of the most common reasons for claim denials in telehealth billing is lack of eligibility verification. Insurance providers have different coverage policies for telehealth services, and failing to confirm a patient's eligibility can result in payment rejections or delays.

✅ Best Practice:

• Confirm the patient’s insurance plan covers telehealth services before each visit.
• Check co-pays, deductibles, and covered CPT codes to prevent billing discrepancies.
• Use automated verification systems to reduce manual errors and administrative workload.

💡 How Bridge Billing Services Helps:
Bridge Billing Services ensures real-time insurance verification, allowing providers to confirm telehealth coverage before an appointment. Our automated eligibility checks reduce claim denials, ensuring a seamless revenue flow.

2. Accurately Document Telehealth Encounters to Justify Medical Necessity

Proper documentation is crucial for telehealth reimbursement approval. Payers require detailed records to confirm that a telehealth service was medically necessary and met the required standard of care.

✅ Best Practice:

• Include chief complaints, diagnoses, treatment plans, and provider-patient interactions in patient records.
• Document the start and end time of telehealth visits for time-based billing codes.
• Store documentation securely to comply with HIPAA and payer-specific audit requirements.

💡 How Bridge Billing Services Helps:
Our billing experts assist in proper documentation and coding to ensure your telehealth claims meet payer requirements, preventing costly denials due to insufficient medical necessity justification.

3. Optimize Coding and Billing Workflows for Quick Claims Processing

Using incorrect CPT codes, HCPCS modifiers, or place of service (POS) codes can lead to billing rejections, delays, or underpayments. Since each payer has different billing requirements, staying compliant with the latest telehealth coding guidelines is essential.

✅ Best Practice:

• Use correct telehealth modifiers like:
  • Modifier 95 – Synchronous telehealth service
  • Modifier GT – Interactive audio & video communication
  • POS 02 or POS 10 – Differentiating telehealth from in-person visits
• Stay updated on payer-specific CPT codes and reimbursement policies.
• Utilize automated billing software to reduce manual errors and streamline claims processing.

💡 How Bridge Billing Services Helps:
Our team ensures error-free claims submission, reducing the risk of denied or delayed claims. We stay updated on the latest CPT codes, modifiers, and payer policies, so your practice always remains compliant.

4. Stay Compliant with State and Federal Telehealth Billing Regulations

Telehealth reimbursement policies are continuously evolving, with Medicare, Medicaid, and private payers updating their coverage guidelines regularly. Staying compliant with state-specific laws and federal telehealth billing regulations is essential for avoiding audits and payment retractions.

✅ Best Practice:

• Monitor CMS (Medicare) updates and state Medicaid telehealth guidelines.
• Ensure providers have the necessary licensure and credentialing for interstate telehealth services.
• Maintain HIPAA compliance by using secure telehealth platforms and encrypted data storage.

💡 How Bridge Billing Services Helps:
We continuously track regulatory changes and payer policy updates, ensuring your practice remains compliant. Our HIPAA-compliant processes safeguard your practice from billing errors, legal risks, and reimbursement delays.

5. Outsource Telehealth Billing to a Trusted Medical Billing Partner

Telehealth billing is complex and time-consuming, requiring expertise in medical coding, compliance, and revenue cycle management. In-house billing teams often struggle to keep up with changing regulations, leading to delayed payments, denied claims, and revenue loss.

✅ Best Practice:

• Partner with a specialized telehealth billing service to reduce administrative burden.
• Improve cash flow with efficient claim processing, denial management, and revenue recovery.
• Focus more on patient care instead of billing complexities

Navigating telehealth billing challenges in 2025 can be overwhelming, but Bridge Billing Services ensures your practice gets maximum reimbursements with minimal denials.

Why Choose Bridge Billing Services?

✔ Expert telehealth billing solutions tailored to your practice
✔ Seamless integration with Epic, Jane, and other EHR platforms
✔ HIPAA-compliant, accurate claim submission
✔ Faster reimbursements & reduced claim denials
✔ Ongoing payer policy monitoring to ensure compliance

💡 Don’t let billing complexities hold back your telehealth practice!

📞 Schedule a free consultation today and let Bridge Billing Services handle your telehealth billing while you focus on delivering quality patient care!

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