How does telemedicine coding differ from in-person care coding?

• A. Telemedicine coding uses the same CPT codes as in-person with no modifiers
• B. Telemedicine is not billable
• C. Telemedicine may have specific CPT codes, modifiers, and location guidelines; coverage varies by payer
• D. Telemedicine requires no documentation

Answer: (C)

Telemedicine coding isn’t just about using the same visit codes as in-person care. You’ll typically use the standard CPT codes for the service, but you must indicate that the encounter was delivered remotely by adding a telemedicine modifier (such as 95 to show real-time telemedicine) and sometimes by using a place-of-service code that reflects telehealth (often 02). In addition, many payers have their own telehealth codes or specific rules, so which codes and modifiers you use can vary by payer. Because of that variation, coverage is not uniform across all payers or programs; Medicare, Medicaid in different states, and private insurers may have different requirements for modality (audio-video vs. audio-only), documentation, and eligibility. Documentation remains essential, describing the visit, modality, patient location, and any consent or privacy considerations. So telemedicine coding is defined by the combination of codes, modifiers, and location rules, with payer-specific requirements driving exactly how it’s billed.