Wrong modifier or place of service
Claims denied for a POS or modifier the payer does not accept. We maintain a payer-by-payer telehealth matrix and apply it at the scrubber.
Home / Specialties / Telemedicine
Telemedicine medical billing services
Telemedicine billing has changed every year since 2020, and the rules still differ between Medicare, each state's Medicaid program and every commercial payer. Getting paid means knowing which codes, modifiers and places of service each payer wants this month, and which services they will not cover virtually at all.
What makes telemedicine billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether telemedicine claims pay the first time.
- Place of service 02 versus 10 and modifiers 95, GT and GQ are applied differently by payer; Medicare, Medicaid and commercial plans do not agree.
- Audio-only visits have their own codes and coverage limits, and some payers require documentation of why video was not used.
- Medicare's telehealth coverage list and originating-site rules continue to shift with legislation, so what was billable last quarter may not be now.
- State licensure and payer parity laws determine whether a visit across state lines is payable at all.
Denials we see most in telemedicine
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Non-covered services
Services denied because the payer does not cover them virtually. We check coverage before scheduling where possible.
Audio-only documentation
Audio-only visits denied for missing required statements. We provide a documentation template.
How Core MB bills for telemedicine
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new telemedicine providers runs in the same system, tracked live in your client portal.
- A living telehealth rules matrix by payer, updated as policies change.
- Scrubber rules for POS, modifiers and covered services so denials stop before submission.
- Documentation templates for video, audio-only and consent requirements.
Everything in the service
The full revenue cycle as standard for telemedicine practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Telemedicine billing questions
Why do telehealth claims keep getting denied?
Because the rules are not uniform. Each payer has its own modifiers, places of service and covered-service lists, and they change. We track them individually rather than applying one rule to everything.
Can we bill audio-only visits?
Often, with the right codes and documentation, but coverage varies by payer and service. We confirm before you build a workflow around it.
Do you follow Medicare's telehealth changes?
Yes. Medicare's covered list and originating-site rules are tied to legislation that changes regularly; we update our rules the week they take effect.
How do we get started with Core MB for telemedicine billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new telemedicine providers can start at the same time.
Find out what your telemedicine billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.