Delivering care to rural and remote communities is vital, and proper telehealth billing ensures providers can keep serving these areas. In 2025, understanding which services can be billed virtually, along with the right codes and regulations, is crucial. Here’s a streamlined guide to help rural providers bill accurately while avoiding errors that could lead to serious consequences.

Telehealth CPT Codes for Rural Care

Telehealth bridges gaps where in-person care is tough to access:

• CPT 99251 (and related consult codes): Use for virtual consults in rural hospitals, critical-access facilities, or long-term care settings. Document complexity as you would for in-person visits.
• E/M Codes (99213–99215): Common for follow-ups or chronic care management via telehealth.
• Specialty Consults: Billable if they meet clinical and documentation standards.

Modifiers and Place of Service (POS) Codes

Modifiers:

• 95: For real-time audio-video telehealth services.
• G0: Rarely used for specific behavioral or facility-based programs—check payer rules.
• GT: Accepted by some payers instead of 95, but confirm first.

POS Codes:

• 02: Patient is at a rural clinic or health center.
• 10: Patient is at home, increasingly common in some rural areas.

Payer Rules for Rural Telehealth

• Medicare: Telehealth flexibilities extend through September 30, 2025, covering POS 02 and 10. Virtual supervision is allowed for certain services through December 31, 2025.
• Medicaid: State policies vary. Many support audio-only visits in low-bandwidth areas, but documentation requirements differ.
• Commercial Payers: Policies vary—some require Modifier 95 and specific POS codes, others accept GT or offer rural-specific reimbursement. Always verify.

Common Billing Scenarios

*Audio-only modifiers depend on the payer—check carefully.

Documentation Tips

• Clearly note the patient’s location (e.g., rural clinic or home).
• Specify the telehealth method (audio-video, audio-only, or store-and-forward).
• Document clinical details, like medical decision-making, to meet CPT requirements.
• Record patient consent, especially for audio-only visits.
• Stay updated on state Medicaid rules, as rural telehealth policies can change quickly.

Key Takeaways

Billing telehealth for rural patients in 2025 is critical for access to care. Use CPT codes like 99251 for consults, apply modifiers (95 or GT) and POS codes (02 or 10) correctly, and document thoroughly to stay compliant. Check payer-specific rules, especially for Medicaid and commercial insurers, to avoid denials and keep care accessible where it’s needed most.