Current Telehealth Coding and Compliance Standards for Physicians-Webinar Recording

Video Transcription

Video Summary

In this comprehensive webinar, Sonal Patel addresses osteopathic physicians on the latest telehealth coding and compliance standards as of December 12, 2025, highlighting the rapidly evolving telehealth landscape shaped by the COVID-19 pandemic, government shutdown, and recent Medicare final rules. She details the impact of the 2025 federal government shutdown, which temporarily halted many telehealth flexibilities, causing claim payment delays and requiring patient refunds due to retroactive reinstatements of waivers through January 30, 2026.<br /><br />Patel explains Medicare’s telehealth policies, emphasizing permanent allowances for behavioral health telehealth without geographic or location restrictions and the temporary extension for therapists (PT, OT, SLP, audiologists) through January 30, 2026. She underscores critical billing requirements such as appropriate place-of-service codes (02 for locations other than home, 10 for the patient’s home), mandatory HIPAA-compliant telehealth platforms, patient consent documentation, and correct modifier usage (e.g., 95 for synchronous audio-video).<br /><br />The presentation also covers state-level telehealth regulations, focusing on Ohio and Illinois, which illustrate significant variations in definitions, modalities (live video, store-and-forward, remote patient monitoring), licensing, and consent requirements. Commercial payers like Blue Cross Blue Shield and Cigna have their distinct policies, often favoring traditional evaluation and management (E/M) codes over newly introduced CPT telehealth codes. Patel highlights prevalent billing pitfalls, including incorrect modifiers, places of service, insufficient documentation, and telehealth consent issues, which risk triggering audits and fraud investigations.<br /><br />She reviews recent CMS updates about virtual supervision and behavioral health in-person visit requirements, billing frequency limits, and stresses the importance of compliance education, updated EMR templates, and creating payer-specific telehealth matrices for successful billing. Overall, Patel advocates for meticulous adherence to telehealth regulations to mitigate audit risk and ensure proper reimbursement as telehealth policies continue to evolve beyond January 2026.

Keywords

medical documentation

seven dirty words

documentation standards

medical decision-making

note bloat

compliance in charting

narrative documentation

time-based coding

patient-specific documentation

telehealth coding

osteopathic physicians

COVID-19 pandemic

2025 federal government shutdown

Medicare telehealth policies

behavioral health telehealth

telehealth billing requirements

HIPAA-compliant platforms

place-of-service codes

telehealth modifiers

state telehealth regulations

commercial payer policies

telehealth billing pitfalls

CMS telehealth updates