Telehealth CPT Codes and Modifiers for 2026: A Billing Reference for Practices

Virtual visits are now a permanent part of how most practices operate. But the billing rules that govern them have gone through a significant restructuring and the 2026 code set looks different from what many teams are still using.

This post covers the current telehealth CPT codes, which modifiers apply to which situations, how Place of Service codes affect reimbursement and what your billing team should act on now.

Why Your Old Telehealth Codes Are Getting Denied

The AMA introduced a dedicated telehealth code series (CPT 98000 through 98016) to standardize how virtual visits are reported. At the same time, telephone codes 99441 through 99443 were permanently deleted. Any claim submitted with those codes in 2026 is denied automatically.

The more important development is that Medicare chose not to adopt most of the new 98000-series codes. This created two separate billing tracks that every practice must now manage.

Medicare vs. Commercial Payers: You Cannot Bill Them the Same Way

Medicare

Medicare does not reimburse CPT codes 98000 through 98015. For Medicare telehealth visits, use:

• 99202 through 99215 with the appropriate Place of Service and modifier
• 98016 for brief virtual check-ins of 5 to 10 minutes with established patients (this replaced the deleted G2012)
• 99421 through 99423 for asynchronous e-visits through a patient portal

Medicare identifies a visit as telehealth through the Place of Service code and modifier, not through a telehealth-specific CPT code.

Commercial and Medicaid Payers

Many commercial payers and state Medicaid programs accept the new 98000-series codes, split into two groups:

• Audio-video visits (98000 through 98007): Used for live video encounters. Code selection is based on MDM complexity or total time and whether the patient is new or established.
• Audio-only visits (98008 through 98015): These replaced the deleted telephone codes 99441 through 99443 and apply to synchronous phone-only visits.

When billing 98000 through 98015 to commercial payers, you do not need to add Modifier 95 or 93. The telehealth modality is already built into the code descriptor.

CPT 98016 is accepted by both Medicare and most commercial payers for brief synchronous visits of 5 to 10 minutes with established patients.

Payer adoption of the 98000-series varies. Confirm which codes each payer accepts for audio-video and audio-only encounters before billing. Payer-specific coverage rules differ more than most billing teams expect. Assuming a payer follows Medicare rules is one of the most common reasons telehealth claim denials occur.

Which Modifier Goes on Which Claim

Modifier 95: Audio-Video Telehealth

Modifier 95 identifies a service delivered via real-time audio and video. Both must be present for the full visit.

Use it when billing commercial payers with traditional E/M codes (99202 through 99215). Do not use it for Medicare, for audio-only visits or when billing 98000-series codes where the modality is already in the code descriptor.

Modifier 93: Audio-Only Telehealth

Modifier 93 identifies services delivered by phone or another audio-only system with no video.

Use it when billing Medicare for audio-only visits alongside standard E/M codes. Do not use it when billing 98008 through 98015 codes to commercial payers.

Medicare extended audio-only telehealth coverage through December 31, 2027. Some commercial payers have restricted audio-only reimbursement to behavioral health only, so verify payer policies before billing audio-only for other visit types.

Modifier GT: Largely Obsolete

Medicare no longer requires Modifier GT and most commercial payers have moved away from it. The only remaining exception is Critical Access Hospitals billing under Method II.

POS 02 vs. POS 10: The Difference That Affects Your Reimbursement Rate

POS codes tell the payer where the patient was located. This directly determines how much you get paid.

• POS 10 applies when the patient is at home. It pays at the higher non-facility rate, equivalent to in-office reimbursement.
• POS 02 applies when the patient is at a clinic, office, skilled nursing facility or any non-home location. It pays at the lower facility rate.

The most common mistake is applying POS 02 to every telehealth visit regardless of patient location. Practices that do this consistently undercharge on the majority of their telehealth claims. Document where the patient is connecting from at every encounter.

Quick Reference Table

Payer	Visit Type	CPT	Modifier	POS
Medicare	Audio-video	99202-99215	None	02 or 10
Medicare	Audio-only	99202-99215	93	02 or 10
Medicare	Brief check-in	98016	None	02 or 10
Commercial	Audio-video	98000-98007	None	02 or 10
Commercial	Audio-only	98008-98015	None	02 or 10
Commercial (E/M)	Audio-video	99202-99215	95	02 or 10

What Every Telehealth Claim Needs in the Documentation

Missing documentation is a leading cause of telehealth denials and audit recoupments. Every claim should be supported by:

• Location of both provider and patient at time of service
• Technology used (audio-video or audio-only)
• Patient consent for telehealth
• Total time or MDM basis for code selection
• If audio-only, confirmation that video was available but not used and the reason

Running the verification process before each visit also catches coverage mismatches early, before they become denials. Practices running high telehealth volume benefit from a denial management process that tracks documentation gaps by claim type so patterns get caught before they compound into larger A/R problems.

Five Things to Fix Before Your Next Telehealth Claim

1. Remove deleted codes. Confirm 99441 through 99443 and G2012 are flagged invalid in your billing system.
2. Build two billing pathways. Route Medicare claims through standard E/M with POS and modifier. Route commercial payer claims through 98000-series codes where the payer accepts them.
3. Verify payer policies. Call your top payers and confirm which codes they accept for audio-video and audio-only visits.
4. Update EHR templates. Add fields for patient location, technology type and consent to support accurate POS coding.
5. Audit recent claims. Pull 20 to 30 telehealth claims from the past 60 days and check for deleted codes, incorrect POS and modifier mismatches. If you are seeing patterns, that is a medical coding review worth doing before the errors scale. Coding gaps compound faster than most practices realize.

Telehealth billing is one of the most payer-dependent areas of revenue cycle management. If your practice is seeing denials or your team is uncertain about which codes apply to which payers, contact MedLife MBS for a free billing assessment.